Neurosurgery clinics of North America
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The major changes in health care delivery today further cloud the perspectives of patient autonomy, participation, and justice and the ideals of the virtuous practice of medicine. A Workable Integrative Negotiation approach with COAST permeating the medical setting and health agenda, however, can help promote effective and ethical participatory communication in medicine. Clearly, instituting such change in a non-surgical decision-making procedure requires a new culture among all participants. ⋯ Instituting an outcome-based reimbursement system among government and providers can serve as a quasi-selection process based on the superseding objectives of the community at large. Finally, a participatory citizenry (from physicians to patients to society-at-large) that balances violence prevention, communication, innovation, community involvement, and appropriate treatment could advance optimal civic health. The challenge is to initiate such change with the communication principles outlined herein.