Applications of Medical Mediation: A Systematic Review of Its Role in Healthcare Dispute Resolution and Bioethical...

Background: Medical mediation offers a patient-centered, collaborative alternative to traditional resolution methods for healthcare conflicts that is gaining international traction in an increasingly complex environment of advancing technology and diverse patient populations. This systematic review aims to synthesize the literature on medical mediation and analyze its clinical applications, conflict typologies, involved actors, mediation methodologies, legal frameworks, and theoretical underpinnings. Methods: A systematic search was conducted in PubMed and Scopus for English-language articles published between 1984 and 2025. Results: Of 656 initial records, 152 studies met the inclusion criteria and were categorized across six domains: clinical context, actors involved, conflict type, mediation framework, legal/policy structure, and theoretical foundations. Most studies originated from high-income countries, particularly the U.S. and U.K., with notable expansion after 2010. Medical mediation was most frequently applied in bedside care, end-of-life decision-making, and managed-care disputes. While ethics consultants were the primary mediators, increasing involvement of trained clinicians and institutional actors was also observed. Most studies emphasized generic bioethical mediation frameworks, with some focused on formalized models and training. Legal frameworks varied, and an increasing number of countries have been adopting institutional or national programs to support mediation. Conclusions: Medical mediation is an efficient tool for resolving complex clinical conflicts, enhancing communication, and preserving therapeutic relationships. Its institutionalization, through law and training, is key to the promotion of justice, transparency, and ethical integrity in modern healthcare systems.