The current version of the patch handles conflicts through the web interface. It is still not perfect as it will break if there is a rename that conflicts with a web change (but so will the other Rcs plugins I think). It also commits a revision with conflict markers if there is a conflict requiring such markers... ick.
Note: This patch requires the Monotone perl module, which is only available in Monotone 0.36 or later. The module is in the Monotone contrib/ directory. While 0.36 is relatively new, that Monotone module itself will work with a monotone binary back quite a few releases.
Apparently this module did't make some versions of the monotone 0.36 release tarball. It is available from the monotone repository here: <http://viewmtn.angrygoats.net/branch/changes/net.venge.monotone>.