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Abstract
On the part of the patient, healthcare demands unconditional trust in
the professional. But what is the nature of this trust, and to what extent
is it justified? How significant is the fallout when it is abused?
Incorporating sociological, psychological and philosophical approaches,
this book examines notions of trust in the self, others and systems in
the field of healthcare. The text explores:
? rational and emotional aspects of trust
? power balances between the patient and healthcare professional
? historical crises of trust in healthcare, considering the impacts and
the lessons learned
? means of strengthening public trust in the healthcare system and its
workforce
Distinctive in its breadth and coverage, Examining Trust in Healthcare
provides a multidisciplinary perspective of a key element of patient
care. This makes the book fundamental reading for students, academics
and professionals across all branches of healthcare, as well as an
important resource for those with professional and academic interests
in the psychology and sociology of health.
This book has a lot to commend it not least that it shows the complexity and diversity of the approaches and arguments about trust and trust relations...' - Social Policy
'Though theoretically accomplished, the book is sufficiently accessible for a wide readership.' - Sociology of Health & Illness
All of us will need to trust the healthcare system as well as individual healthcare workers at some point. But why do we trust 'professionals'? Is it unconditional? As practitioners, do we realise the legal, ethical and professional issues intertwined with 'being trusted'? Read this book for an absorbing discussion of trust.
DAVID PILGRIM (BSc, MSc, MPsychol (Clin), PhD) is a Clinical Psychologist and Medical Sociologist. Currently is Clinical Dean Teaching Primary Care Trust for East Lancashire, UK, Visiting Professor, Department of Primary Care, University of Liverpool and Honorary Professor, Lancashire Postgraduate School of Medicine and Health, University of Central Lancashire. He has published over 60 articles in peer reviewed journals and several books. For Palgrave the latter include Mental Health and Inequality (2002) and Mental Health Policy in Britain (2001). Also he has published Key Concepts in Mental Health and A Short Introduction to Clinical Psychology (with Katherine Cheshire) (for Sage). He is also the co-author with Anne Rogers of A Sociology of Mental Health and Illness now in its third edition for Open University Press, which won the 2006 BMA book competition in the mental health category.
FLORIS TOMASINI (BA(Hons), PGCE, MA, PhD) is a Medical Ethicist. Currently he is Research Associate Lancaster University, UK (2005-2007); De facto Co-ordinator on EU project - Institutionalising Ethics in Science Policy involving 12 European partners. His previous roles were as Research Associate IPPP, Lancaster University (2003-4) in association with English Heritage - strategies in the regeneration of blighted urban areas and Research Fellow (2002-3) in association with Royal Preston Hospital& the disablement services centre. Exploring the experience of amputees with phantom limb - a phenomenological approach. Teaching Assistant (2002-7) mainly on the undergraduate philosophy programme. Publications include: M. Levitt& F. Tomasini 'Bar-coded children; the England and Wales National DNA database' Genomics, Society& Policy submitted Feb/Mar 2006; F. Tomasini 'Imagining Human Enhancement: whose rationality, which justice?' Theoretical Medicine& Bioethics Forthcoming 2006/7 ; F. Tomasini 'Exploring the ethical justification for self-demand amputation' Ethics& Medicine. Forthcoming Spring 2006;F. Tomasini 'The case of self demand amputees: a dilemma for professional bioethics?' in Arguments& Analysis in Bioethics Eds. Matti Hayry et al., Rodopi, Fothcoming 2006.
IVAYLO VASSILEV (BA, MA, PhD) is a Political Sociologist and currently Research Associate in the Teesside Business School, University of Teesside, UK. Whilst completing his PhD (on the sociology of trust) at Lancaster University he was a tutor in sociology. Forthcoming publications include: Globalisation and Industrial Change in the Clothing Industry of Transcarpathia, Western Ukraine: A Micro-Level View, co-authored with Christos Kalantaridis and Svitlana Slava, Environment and Planning; 'Risk', 'Trust' and the Myth of 'Mental Health Services co-authored with David Pilgrim, Journal of Mental Health; and Ambiguities of Trust: Postsocialism, Markets and Underdevelopment, East European Politics and Societies .
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Cover | Cover | ||
Contents | v | ||
List of Figures and Boxes | vii | ||
Foreword | viii | ||
Introduction | x | ||
1 Connotations of Trust | 1 | ||
Overview of the structure and rationale of the book | 1 | ||
Overview of our approach to analysis | 2 | ||
How we use and understand the word 'trust' | 2 | ||
What is trust? | 11 | ||
Summary | 12 | ||
2 Interpersonal Aspects of Trust | 13 | ||
Introduction | 13 | ||
Assumptions about successful clinical encounters | 13 | ||
Trusting the professional: competence, honesty and integrity | 15 | ||
Mechanisms for maximizing personal trustworthiness | 23 | ||
Trusting the patient | 24 | ||
Paternalism and the prospects of mutuality | 27 | ||
The social context of relationships in healthcare | 29 | ||
Summary | 34 | ||
3 Psycho-social and Psycho-ethical Aspects of Trust | 36 | ||
Introduction | 36 | ||
Trust, attachment, dependency and ontological security | 37 | ||
The failure of trust in childhood | 46 | ||
Malign leadership and mass conformity | 49 | ||
Implications for trust in healthcare | 55 | ||
Summary | 60 | ||
4 Ethics, Trust and Healthcare | 61 | ||
First model for ethical healthcare: virtue ethics | 61 | ||
Second model for ethical healthcare: duty ethics | 72 | ||
Outlining integrated approaches to ethics and trust in healthcare | 81 | ||
Summary | 82 | ||
5 Social Aspects of Trust | 83 | ||
Introduction | 83 | ||
Trust as positive and negative dependence | 84 | ||
Autonomy and the embeddedness of trust in social relationships | 86 | ||
Recognition, positive dependence, and trust as a need | 91 | ||
Trust in a 'risk society' | 100 | ||
Summary | 115 | ||
6 Framing Trust in Healthcare through Case Study Analysis | 117 | ||
Introduction | 117 | ||
Medical experiments, scandals and trust | 119 | ||
Medical controversies and trust | 131 | ||
Routine breakdowns of trust | 145 | ||
Summary | 147 | ||
7 Trust in Systems | 149 | ||
Introduction | 149 | ||
Trust in a changing healthcare system | 151 | ||
Stakeholder perspectives on service quality | 152 | ||
Professionally led governance: a culture of trust in persons? | 156 | ||
Government-led governance: a culture of trust in systems? | 162 | ||
Patient-centred services and the dominant models of healthcare governance | 172 | ||
Summary | 178 | ||
8 Conclusion | 180 | ||
Analytical considerations | 182 | ||
Political considerations about trust in healthcare | 185 | ||
Glossary | 192 | ||
Bibliography | 204 | ||
Index | 216 |