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I. INTRODUCTION
In early July of 2006, yet another scandal regarding professional and ethical standards in Israeli hospitals broke out: it was revealed in Haaretz, Israel's most influential newspaper, that a series of experiments in women and the elderly were conducted at several major Israeli hospitals without obtaining patient informed consent and approval by the appropriate authorities.1 A couple of weeks earlier, the same paper published a cover story in its weekend magazine on allegations of medical malpractice in the treatment given to the wife of a senior physician at the hospital where he works.2 The incident was followed, he claimed, by a series of cover-ups and attempts to silence discussion of what had happened. He now walks the corridors of his hospital feeling that he must speak up against what he perceives as the systematic cover-up of medical malpractice cases and the absence of any effort to learn from past mistakes.3
These are seemingly two isolated events. In fact, they are not. As this article will demonstrate, these incidents are representative of a much broader problem that extends beyond the scope of individual misconduct or negligence. I believe that these occurrences are indicative of the absence of effective channels of communication within these institutions, which, in turn, fosters misunderstandings and mistakes, escalates conflict, encourages defensive treatment of complaints, and masks incompetence and wrongdoing. I term this predicament organizational ailment. Obviously, this problem is not unique to the healthcare arena, but it is prevalent and visible in the medical setting because of the complex and high-pressure reality in which decisions need to be made, and the often fatal consequences of mishaps there. Hospitals are hierarchical institutions in which the most quotidian decisions could be issues of life and death and are reached based on coordination among a diverse group of practitioners and under extreme time pressure and financial constraints. In Israel, this reality is further compounded by an industry in which the operator of the major hospitals, the Ministry of Health, is also the regulator and monitor of their functioning.
The American experience with "internal dispute resolution"4 ("IDR") or "conflict management systems"5-that is, the development of internal, systemized capacity for handling conflict within organizations-has proven that, in certain cases, these mechanisms can be instrumental in...