医療者・患者関係における信頼
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概要
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The word 'trust' is used in a variety of situations. We often use the word to describe the people's perception of institutions. For instance, WorldCom and Enron were called trustbusters, mainly because they did not fulfill the moral standards expected of their businesses. We also use the word to describe the relations between persons. Here, the ambiguity of "A trusts B" becomes more apparent. Sometimes it is used in the context of business transactions, meaning "B will carry out the contract he made with A." But we also use it to describe a particular aspect of personal relationships, such as "She has cared about my welfare so much, working long hours, and so I have full trust in her." Following Annette Baier's analysis, we can divide the meaning of 'trust' into two categories : reliance (reliance on others' particular attitudes and reactions, or on their dependable habits) and trust (a special kind of reliance, i. e. reliance on another's good will toward one). In the medical context, reliance can be strengthened by reducing medical errors and implementing measures to protect and respect patients' welfare, while it seems there are no easy prescriptions for medical professionals to earn trust, since it is difficult for a patient to see directly whether her medical providers have good will towards herself. All they can do is to create a climate of trust where trust could possibly grow. To aim at gaining trust directly will be self-defeating and sometimes even bring about undesirable consequences. Today many emphasize the importance in medical settings of trust relationships between lay and professional, as distinct from mere reliance relationships. I contend, however, that what is needed is to try to increase patients' reliance on medical providers' attitudes and the medical world in general, and if things go well, medical professionals may earn trust as a result of their efforts.
- 日本医学哲学・倫理学会の論文
- 2003-10-05