Engagement means opening up your heart.
If you want to engage with someone, you have to truly be receptive to their attempts to communicate and seek ways to meet shared expectations with respect to aligned goals.
Whatever the relationship or duty of care, to seek to invalidate a partner is nothing less profound than a domestic abuse.
Whether you are a significant other, a patient or a clinical staff member negotiating the whims of a healthcare organisation, your partnership in the care relationship involves an imbalance of power.
Harm arises when the wielder of that imbalance of power absolves themselves of all accountability to anything but their own desired outcomes.