‘Trust my doctor, trust my pancreas’: trust as an emergent quality of social practice

Philosophy, Ethics, and Humanities in Medicine

Simon Cohn¹ 

[1] Reader in medical anthropology, Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK

关键词: Quality;    Practice theory;    Diabetes;    Trust;   

Others  :  1221129
DOI  :  10.1186/s13010-015-0029-6

 received in 2014-08-14, accepted in 2015-05-25,  发布年份 2015

【 摘 要 】

Background

Growing attention is being paid to the importance of trust, and its corollaries such as mistrust and distrust, in health service and the central place they have in assessments of quality of care. Although initially focussing on doctor-patient relationships, more recent literature has broadened its remit to include trust held in more abstract entities, such as organisations and institutions. There has consequently been growing interest to develop rigorous and universal measures of trust.

Methods

Drawing on illustrative ethnographic material from observational research in a UK diabetes clinic, this paper supports an approach that foregrounds social practice and resists conceiving trust as solely a psychological state that can be divorced from its context. Beyond exploring the less-than-conscious nature of trust, the interpretations attend to the extent to which trust practices are distributed across a range of actors.

Results

Data from clinical encounters reveal the extent to which matters of trust can emerge from the relationships between people, and sometimes people and things, as a result of a wide range of pragmatic concerns, and hence can usefully be conceived of as an extended property of a situation rather than a person. Trust is rarely explicitly articulated, but remains a subtle feature of experience that is frequently ineffable.

Conclusions

A practice approach highlights some of the problems with adopting a general psychological or intellectualist conception of trust. In particular, assuming it is a sufficiently stable internal state that can be stored or measured not only transforms a diffuse and often ephemeral quality into a durable thing, but ultimately presents it as a generic state that has meaning independent of the specific relationships and context that achieve it. Emphasising the context-specific nature of trust practices does not dismiss the potential of matters of trust, when they emerge, to be transposed to other contexts. But it does highlight how, on each occasion, trust as a relational quality is ways ‘done’ or ‘achieved’ anew.

【 授权许可】

   
2015 Cohn.

【 参考文献 】

• [1]Thom DH, Kravitz RL, Bell RA, Krupat E, Azari R. Patient trust in the physician: relationship to patient requests. Fam Pract. 2002; 19:476-83.
• [2]Gille F, Smith S, Mays N. Why public trust in health care systems matters and deserves greater research attention. J Health Serv Res Policy. 2015; 20(1):62-4.
• [3]Francis R. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. The Stationery Office, London; 2013.
• [4]Veracity Index: Trust [https://www.ipsos-mori.com/Assets/Docs/Polls/Feb2013_Trust_Topline.PDF]
• [5]Mechanic D. Changing medical organization and the erosion of trust. Milbank Q. 1996; 74:171-89.
• [6]Rowe R, Calnan M. Trust relations in health care—the new agenda. Eur J Public Health. 2006; 16:4-6.
• [7]Taylor-Gooby P. Markets and Motives Trust and Egoism in Welfare Markets Markets and Motives Trust and Egoism in Welfare Markets. J Soc Policy. 1999; 28:97-114.
• [8]O’Neill O. Autonomy and Trust in Bioethics. Cambridge University Press, Cambridge; 2002.
• [9]Armstrong D. The myth of concordance: response to Stevenson and Scambler. Health (London). 2005; 9:23-7.
• [10]Brown PR. Trusting in the New NHS: instrumental versus communicative action. Sociol Health Illn. 2008; 30:349-63.
• [11]Calnan MW, Sanford E. Public trust in health care: the system or the doctor? Qual Saf Health Care. 2004; 13:92-7.
• [12]Gilson L. Trust and the development of health care as a social institution. Soc Sci Med. 2003; 56:1453-68.
• [13]Meyer S, Ward PR. Reworking the sociology of trust: making a semantic distinction between trust and dependence. The Future of Sociology. 2009.
• [14]Lewis JD, Weigert A, Dame UN, Lewis D. Trust as a Social Reality. Soc Forces. 1985; 63:967-85.
• [15]Hardin R. The Street-Level Epistemology of Trust. Politics & Society. 1993; 21:505-529.
• [16]Luhmann N. Familiarity, Confidence, Trust: Problems and Alternatives. Trust: Making and Breaking Cooperative Relations. Gambetta D, editor. Oxford University Press, Oxford; 2000.
• [17]Newton K. Trust, Social Capital, Civil Society, and Demoncracy. Int Polit Sci Rev. 2001; 22:201-14.
• [18]Thom DH, Hall MA, Pawlson LG. Measuring Patients’ Trust In Physicians When Assessing Quality Of Care. Health Aff. 2004; 23:124-32.
• [19]Hall M, Camacho F, Dugan E, Balkrishnan R. Trust in the medical profession: conceptual and measurement issues. Health Serv Res. 2002; 37(5):1419-39.
• [20]Harvey N, Twyman MHC. Determinants of trust in advice: Studies of the effectiveness of risk communication. Int J Psychol. 2008; 43:198.
• [21]Baier A. Trust and Antitrust Ethics. 1986; 96:231-260.
• [22]Skirbekk H, Middelthon A-L, Hjortdahl P, Finset A. Mandates of trust in the doctor-patient relationship. Qual Health Res. 2011; 21:1182-90.
• [23]Brown PR, Alaszewski A, Swift T, Nordin A. Actions speak louder than words: the embodiment of trust by healthcare professionals in gynae-oncology. Soc of Health Illness. 2011; 33(2):280-295.
• [24]Frederiksen M. Relational trust: Outline of a Bourdieusian theory of interpersonal trust. J Trust Res. 2014; 4:167-192.
• [25]Brown P. The phenomenology of trust: A Schutzian analysis of the social construction of knowledge by gynae-oncology patients. Heal Risk Soc. 2009; 11:391-407.
• [26]Meyer SB, Ward P. Differentiating between trust and dependence of patients with coronary heart disease: Furthering the sociology of trust. Heal Risk Soc. 2013; 15:271-293.
• [27]Khodyakov D. Trust as a Process: A Three-Dimensional Approach. Sociology. 2007; 41:115-132.
• [28]Noddings N. Caring: A Feminine Approach to Ethics and Moral Education. University of California Press, Berkeley; 1984.
• [29]Brodwin P. Everyday Ethics: Voices from the Front Line of Community Psychiatry. University of California Press, Berkley; 2013.
• [30]Barbalet J. A characterization of trust, and its consequences. Theory Soc. 2009; 38(4):367-382.
• [31]Solbjør M. “You have to have trust in those pictures”: a perspective on women’s experiences of mammography screening. Researching Trust and Health. Brownlie J, Greene A, Howson A, editors. Routledge, Oxon; 2008.
• [32]Calnan M & Rowe R. Trust matters in health care. McGraw-Hill International; 2008.
• [33]Peirce CS. How To Make Our Ideas Clear. In: Houser N & Kloesel C, editors. The Essential Peirce Vol 1; 1992:124–141.
• [34]The Social after Gabriel Tarde: Debates and Assessments. Routledge, London; 2010.
• [35]Bourdieu P. The Logic of Practice. Stanford University Press, Stanford; 1990.
• [36]Rouse J. Practice theory. In: Handbook of the Philosophy of Science. 2006.500-540.
• [37]Burchell G. Liberal government and techniques of the self. Econ Soc. 1993; 22(3):267-282.
• [38]Reckwitz A. Toward a Theory of Social Practices: A Development in Culturalist Theorizing. Eur J Soc Theory. 2002; 5:243-263.
• [39]Taylor C. To Follow a Rule. In: Philosophical Arguments. Harvard University Press, Cambridge, MA; 1995: p.165-180.
• [40]Lupton D. Risk. 2nd ed. Routledge, Oxon & New York; 2013.
• [41]Deleuze G. Lecture transcripts on Spinoza’s concept of affect [http://www.webdeleuze.com/php/sommaire.html]
• [42]Montelius E, Giritli-Nygren K. “Doing” risk, “doing” difference: towards an understanding of the intersections of risk, morality and taste. Heal Risk Soc. 2014; 16:431-443.
• [43]Haddow G, Cunningham-Burley S. Tokens of Trust or Token Trust? The case of Population Genetic Data Collections. Trust, Health and Illness. Greene A, Brownlie J, Howson A, editors. Routledge, London; 2008.
• [44]Brown P, Calnan M. The risks of managing uncertainty: The limitations of governance and choice, and the potential for trust. Soc Policy Soc. 2010; 9(01):13-24.
• [45]Charmaz K. Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Sage Publications, Thousand Oaks, CA; 2000.
• [46]Gubrium JF, Holstein JA. Narrative practice and the coherence of personal stories. Sociol Q. 1998; 39:163-187.