Menu Expand
Examining Trust in Healthcare

Examining Trust in Healthcare

David Pilgrim | Ivaylo Vassilev

(2010)

Additional Information

Book Details

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