Even before trust became a buzzword, theoretical developments were made, which have instigated the development of two forms of trust which are described as personal trust and system trust/confidence. However, this distinction remained rather secondary in the overall literature. There is an overall lack on the historical developments of these forms of trust, their internal logic and how they interlink, overlap, or work against each other. The paper aims to advance these three aspects: first through a historical overview of the (...) semantic of this distinction, followed by a theoretical reconstruction of the historical material and third by demonstrating how these theoretical concepts can be applied to political crises (Revolutions of 1989), thus revealing their logic and mutual interlocking. (shrink)

Patients’ trust in their physicians improves their health outcomes because of better compliance, more disclosure, stronger placebo effect, and more physicians’ trustworthy behaviors. Patients’ autonomy may also impact on health outcomes and is increasingly being emphasized in health care. However, despite the critical role of trust and autonomy, patients that naïvely trust their physicians may become overly dependent and lack the motivation to participate in medical care. In this article, we argue that increased trust does not necessarily imply decreased autonomy. (...) Furthermore, patients with high levels of trust and autonomy preferences are most likely to have the best health outcomes. We propose a framework for understanding simultaneous trust and autonomy preferences and for recognizing their interactive effects on health outcomes in the dynamic medical encounter. This framework argues that policy makers and health care providers should make efforts to foster not only patients’ trust but also their preferences for autonomy and thus gain the best position for achieving health-related goals. (shrink)

Artificial intelligence is changing healthcare and the practice of medicine as data-driven science and machine-learning technologies, in particular, are contributing to a variety of medical and clinical tasks. Such advancements have also raised many questions, especially about public trust. As a response to these concerns there has been a concentrated effort from public bodies, policy-makers and technology companies leading the way in AI to address what is identified as a "public trust deficit". This paper argues that a focus on trust (...) as the basis upon which a relationship between this new technology and the public is built is, at best, ineffective, at worst, inappropriate or even dangerous, as it diverts attention from what is actually needed to actively warrant trust. Instead of agonising about how to facilitate trust, a type of relationship which can leave those trusting vulnerable and exposed, we argue that efforts should be focused on the difficult and dynamic process of ensuring reliance underwritten by strong legal and regulatory frameworks. From there, trust could emerge but not merely as a means to an end. Instead, as something to work in practice towards; that is, the deserved result of an ongoing ethical relationship where there is the appropriate, enforceable and reliable regulatory infrastructure in place for problems, challenges and power asymmetries to be continuously accounted for and appropriately redressed. Data sharing not applicable as no datasets generated and/or analysed for this study. (shrink)

Vaccine hesitancy has been a major cause for concern throughout the COVID-19 pandemic. The World Health Organization have previously addressed vaccine hesitancy via the ‘3C model’ (Convenience, Complacency, and Confidence). Recent scholarship has added two more ‘Cs’ (Context and Communication) to formulate a ‘5C model’ that is more equipped to adapt to the uncertainties of the pandemic. This paper focuses on the four ‘Cs’ that explicitly concerns trust (Complacency, Confidence, Context, and Communication) and phenomenologically distinguishes confidence from trust. Experts view (...) vaccines in terms of confidence, where the prospect of an undesirable outcome is extremely rare. Hence, not vaccinating and compromising herd immunity is seen to be unreasonable. Hesitant individuals contest the expert perspective and view vaccines in terms of trust, where the prospect of disappointment is likely. From this perspective, to vaccinate is to take a risk, and it is within reason to have the freedom to choose otherwise. This paper focuses on the hesitant perspective to identify the two social indicators of trust in vaccines most prominently shown during the COVID-19 pandemic in the Global North: (i) the expert reaction to hesitant concerns and (ii) the loss of freedom in relation to vaccine requirements. (shrink)

This paper addresses two research questions. The first is theoretical: What is trust? In the first half of this paper we present a distinctive tripartite analysis. We describe three attitudes, here called reliance, specific trust and general trust, each of which is characterised and illustrated. We argue that these attitudes are related, but not reducible, to one another. We suggest that the current impasse in the analysis of trust is in part due to the fact that some writers allude to (...) these distinctions, but unclearly so, whilst others elide them altogether. The second research question focuses on doctor–patient interaction. Trust is often said to be central in medical encounters but this strikes us as too vague. The success of doctor–patient relations in part depends on adopting the most appropriate of the three attitudes we delineate. We argue that reliance is the appropriate attitude for most medical encounters. When circumstances do require trust, the distinction between specific trust and general trust is crucial. We describe medical encounters requiring specific trust. General trust is less often required in medicine; but it is appropriate in some cases and, when called for, it is called for strongly. (shrink)

The philosophy of trust is a relatively small subfield. Nonetheless, it contains within it many important insights. Our contention in this paper is that careful study of this subfield can b...

The general expectation that patients should be willing to trust nurses is rarely explored or challenged despite claims of diminishing public trust in social and professional institutions. Everyday meanings of trust take account of circumstance and suggest that our understanding of what it means to trust is contextually bound. However, in the context of health care, to trust implies a particular understanding which becomes apparent when abuses of this trust are reported and acknowledged as scandals. The predominant assumption in the (...) literature that trust is something that occurs between equally competent adults cannot explain trust in nursing precisely because of the unequal power relationships between patients on the one hand and healthcare professionals on the other. Moreover, the tendency to conflate terms such as trust, reliance, confidence and so on suggests that confusion permeates discussions of trust in nursing. In this paper, I argue in support of Annette Baier’s requirement of good will (or lack of ill will) as the essential feature of trust, and outline how this account (i) enables us to make the necessary distinctions between trust on the one hand and ‘trust pretenders’ on the other; and (ii) lays the foundations for understanding trust in relationships, such as those between patients and nurses, where power differentials exist. (shrink)

In this issue, Pila (2009) has criticised the recommendations made by requirements engineers involved in the design of a grid technology for the support of distributed readings of mammograms made by Jirotka et al. (2005). The disagreement between them turns on the notion of “biographical familiarity” and whether it can be a sound basis for trust for the performances of professionals such as radiologists. In the first two sections, this paper gives an interpretation of the position of each side in (...) this disagreement and their recommendation for the design of technology for distributed reading, and in the third the underlying reasons for this disagreement are discussed. It is argued that Pila, in attempting to make room for mistrust as well as trust, brings to the fore the question of having and reflecting upon reasons for trust or mistrust. Pila holds that biographical familiarity is not a sound reason for trust/mistrust, as it seems to obliterate the possibility of mistrust. In response to her proposal, an analysis is proposed of the forms of trust involved in biographical familiarity. In particular, implicit trust is focused upon—as a form of trust in advance of reasons, and as a form of trust contained (in the logical sense) within other reasons. It is proposed that implicit trust has an important role in establishing an intersubjectively shared world in which what counts as a reason for the acceptability of performances such as readings of X-rays is established. Implicit trust, therefore, is necessary for professionals to enter into a “space of reasons”. To insist upon judgements made in the absence of the form of implicit trust at play in biographical familiarity is to demand that radiologists (and other relevantly similar professionals) make judgements regarding whether to trust or mistrust on the basis of reasons capable of being reflected upon, but at the same time leave them without reasons upon which to reflect. (shrink)