Elementary Clinic Lecture for 3rd year medical students at the faculty of Medicine National University of Malaysia Friday 11th April 2003 by Prof Dr Omar Hasan Kasule Sr. MB ChB (MUK), MPH & DrPH (Harvard) Deputy Dean Kulliyah of Medicine, International Islamic University, Kuantan. E-MAIL omarkasule@yahoo.com . WEBSITE: http://doctor-omar.net/


Negotiations are pervasive in leadership, management, public and private life. They involve negotiations with others to reach an acceptable consensus. Discussion in a good way is the basis of negotiation[i]. Discussion is a necessity[ii]. It must have proper etiquette[iii]. It should be based on truth[iv], avoid contradictions[v]. Knowledge is a necessity for any discussion[vi]. Negotiators should not be arrogant[vii]. They should be committed to the discussion[viii] until they reach a conclusion. Some forms of discussion are condemned[ix]. Secret negotiations are discouraged[x]. Discussions may fail and be cut off[xi]. Negotiation is essentially looking for common ground[xii]. Risks can be taken in negotiation[xiii]. Negotiations should not be abandoned just because the other party may cheat or break the agreement reached. Evil people break their covenants time and time again[xiv]. Any agreement reached has to be disowned in case of treachery[xv].  Precautions should always be taken to guard against treachery but in the final analysis trust should be put in Allah[xvi]. Stereotyping should be avoided and every matter should be approached objectively; not every member of a community or group behaves in the same way[xvii]. The overall approach in negotiations should be the just equilibrium and avoidance of extremes[xviii].   


The migration of Sayyidah Zainab from Makka illustrates an example of win-win negotiation. She was accompanied in broad daylight by her brother‑in‑law, Kinanah b. al‑Rabi', armed with a bow and quiver. Some Quraysh who pursued her and a fight nearly broke out. Abu Syfyan then intervened and said to Kinanah "You did the wrong thing in taking the woman away in public under everyone's noses. You know the affliction and disaster which have befallen us as a result of Muhammad's actions. If his daughter is taken away from among us publicly, un­der their noses, people will think that this shows the humiliation which has befallen us as a result of the disaster we suffered, and that it is weakness and feebleness on our part. By my life, we have no need to keep her away from her father, and we have no inten­tion of exacting vengeance in that way. But take the woman back, and when the clamor has died down and people are saying that we have brought her back, slip out secretly with her, and reunite her with her father." Kinanah did so, and when the clamor had died down he took Zaynab out by night and handed her over to Zayd b. Harithah and his companion, and they took her to the Messenger of God ( Tabari 7:75-76).


The Hudaybiyah negotiations also illustrated the principles of win-win. The final terms of the agreement included give and take from both sides. It is reported that Muhammad called 'Ali ibn Abu Talib and said to him: "Write, 'In the name of God, the Merciful, the Compassionate.' " Suhayl, the non‑Muslim delegate of Quraysh interrupted. "Stop," he said, "I do not know either 'the Merciful' or 'the Compassionate.' Write, 'In your name, O God.'" The Prophet of God instructed 'Ali to write accordingly and continued: "Write, 'Following is the text of a pact reached by Muhammad, the Prophet of God and Suhayl ibn 'Amr.' " Suhayl again interrupted. "Stop it. If I accepted you as a Prophet of God I would not have been hostile to you. You should write only your name and the name of your father." The Prophet of God instructed 'Ali to write accordingly, referring to himself as Muhammad ibn 'Abdullah. The agreement had 7 points. (1) Muslims will not perform Umra or Hajj this year (2) Muslims will be permitted to perform Hajj or Umra provided they do not stay more than 3 days in Makka (3) While in Makka Muslims will not bear any arms except sheathed swords (4) Whosoever wishes to join Muhammad (PBUH) or enter into treaty with him will have the liberty to do so (5) Whosoever wishes to join the Quraish enter into treaty with them will have the liberty to do so (6) If anyone went over to Muhammad (PBUH) without the permission of his guardian will be returned back to the Quraish (7) If any of the followers of Muhammad (PBUH) returns to the Quraish, he shall not be sent back.


Negotiation is necessary to protect your interests, and get as much advantage as possible without entering into costly and bruising confrontations. Most conflicts can be resolved through negotiation. Good negotiation turns confrontation into cooperation. Physicians must be able to negotiate with their patients and relative to agree on a treatment plan otherwise a lot of conflicts and misunderstandings will occur.


Learning negotiation skills: Negotiation skills can be learned. They can be improved by experience and discussions with experienced negotiators.


Negotiations can be win-win in which each party leaves satisfied or win-lose in which one party leaves with a feeling of winning and the other leaves with a feeling of having lost. A win-win outcome is the best in a negotiation. It ensures that each party gets the maximum it can from the transaction, part as friends who can work together again. Both objectives and relations be considered. Future relationships may be lost by aggressive pursuit of objectives. Win-win negotiation requires avoiding stereotyping the other party. Such stereotypes confuse your judgment. Win-win negotiation requires avoiding extremes. The just equilibrium is the way to negotiate. Win-win negotiation is joint problem-solving; the alternative is power negotiation using threats, intimidation, and other power tactics that will end in deadlock. Win-win negotiation focuses on positive solutions. It aims at reaching an agreement satisfactory to both sides by a process that is as painless as possible. Satisfaction could be achieved even if one party has through miscalculation compromised its interests. It is all well as long as they are not aware of their mistake.


Win-win negotiation has the following elements: separating people from the problem, looking at interests and not positions, creating options for mutual gain, getting all parties to use objective criteria, enough time to prepare for and carry out negotiations. and optimum circumstances under which negotiation is carried. The focus should be on solving problems and not on personalities. Interests and not positions should be defended. A negotiating position can be given up or changed without giving up your interests. Options for mutual gains should be vigorously explored. Win-win negotiators concentrate on objective criteria. A win-win outcome in negotiations requires enough time to prepare so that decisions and moves are well-studied and are not emotional reactions.



Negotiating is strategy. Enter negotiations with a well worked out strategy, a clear objective, a defined bottomline, and a worst-case scenario. You should get as much information as possible about the negotiating. Negotiation power should be used wisely and in moderation. The aim shoule be win-win situation. Win-lose succeeds in the short run but fails in the long run. Rationality and objectivity should always be observed. Every negotiation involves making concessions and compromises. Success of negotiations requires privacy, patience, and sufficient time. Simultaneous negotiation over several issues at the same time increases the possibility of a compromise. You should be careful about the use of brinkmanship or bluffs. They lead to disaster in most negotiating situations.



Aggressive tactics are pressure tactics involve intimidation and stonewalling,. Friendly tactics include kid glove and good guy/bad guy combinations. Evasive tactics are hiding behind an invisible authority, stonewalling, and deception. Provocative tactics involve erosion of your confidence, provocations and emotions, anger, and personal attacks. Effective approaches involve taking calculated risks, an incremental approach by not throwing all cards at the same time, and thinking about follow-up and implementation during the negotiations.



Any opportunity to build personal relations with negotiating partners should be used. You must be very self-disciplined at all times when you are with the other party to the negotiations. Such discipline will save you from costly mistakes. Discipline yourself to listen to the other party without interruption. Do not react to statements before analyzing them. Do not be hasty in reaching conclusions. The atmosphere of negotiations should be cooperative and not hostile or competitive. Negotiating in a team has advantages over negotiating as an individual. The negotiation session should be planned leaving nothing to chance. Role playing is useful to be prepared for any eventuality. Background information is collected about the issue negotiated, the negotiating parties’ weaknesses and strengths. The following must also be identified for each of the negotiating parties: objective standards for settling issues, satisfactory solutions, interests, limitations, the impact of the suggested solutions, worst case scenario, and alternatives to negotiation. Plan the actual negotiation session and the follow-up to the negotiation. Write a ‘worry’ list of what could go wrong. A negotiation session has the following main stages: setting the agenda, opening the negotiations, demands and offers, narrowing differences between the parties, final bargaining, persuading the other party to cross the last hurdle to agreement, and implementation of the negotiated deal.



It is advisable to start a difficult negotiation by something light, relaxing, and calming for all part in order to break the ice. Too high an initial tension augurs badly for the whole process. Difficult negotiations may have to start with negotiations about negotiations ie setting and agreeing on the rules of the game. The following are barriers to successful negotiations: a negative attitude to negotiations, poor communication skills, lack of knowledge,  lack of confidence in negotiations,  fear of confrontation,  being emotional and not being objective,  being reactive,  treating the other party as adversaries who must lose, and aggressive behavior. Deadlocked negotiations are natural on non-negotiable matters of principle. It is wrong to deadlock on trivial inconsequential issues or procedural matters. Some insincere negotiators want a deadlock. A dead-lock is due to personal factors such as an inflated ego and poor negotiation technic. A strategic negotiator you should never be surprised by a deadlock. You should have anticipated it from the beginning and should have planned a contingency strategy. If you can walk away from a negotiation a deadlock is OK. If you can not, never allow negotiations to proceed to a deadlock because you may then be forced to walk away from the negotiation table and you can not afford it, or you may reveal your handicap and weakness and be forced to make concessions you would have never made for the sake of saving the negotiations. If it is in your interests to continue the negotiations, devise ways and means of getting around a dead-lock. Stay calm and keep negotiating. You have to change the rules of the game or reframe issues. Consider all alternatives and look for options. Utilize maximum flexibility but never lose sight of the final goals and your permanent interests. Stick to objectivity. Stay calm. Avoid ego complications, yours and those of the other party.

[i] (p347 16:125, 29:46, 41:33-34)

[ii] (p373 2:150, 4:165, 6:149, 16;125, 18:54)

[iii] (p 375 6:108, 16:125, 29:46)

[iv] (p375-376 2:91, 3:71, 21:24, p376 3:61)

[v] (p376 2:85, 2:91, 6:91, 25:7-8, 25:20, 54:2)

[vi] (p377 3:66, 10:39, 11:13-14, 22:3, 22:8, 31:20, 40:35 & 17:47, 20:62, 20:103, 21:3, 43:80, 58:1, 58:7-10, 58:12, 60:1, 66:3, 68:23, 71:9)

[vii] (p376 2:87, 28:49-50)

[viii] (p376 28:49-50, 34:24-25, 34:46, 54:2-4)

[ix] (p377 2:139, 2:197, 3:20, 3:66, 4:107, 4:114, 6:121, 18:56, 27:3, 40:4-5, 40:35, 40:56, 40:69, 42:16, 43:58, 58:8-10)

[x] (p370 4:114, 9:78, 17:47, 20:62, 20:103, 21:3, 43:80, 58:1, 58:7-10, 58:12, 60:1, 66:3, 68:23, 71:9)

[xi] (p375 2:258, 3:64, 4:140, 5:68, 7:71, 10:41, 11:35, 11:57, 11:65, 11:93, 21:67, 22:68, 23:26, 26:117-118, 26:168, 28:55)

[xii] (Qur'an 3:64)

[xiii] (Qur'an 8:62)

[xiv] (Qur'an 8:56)

[xv] (Qur'an 8:58)

[xvi] (Qur'an 8:62)

[xvii] (Qur'an 3:75)

[xviii] (Qur'an 2:143)

ęCopyright Professor Omar Hasan Kasule Sr, April 2003