be nondangerous” (Baier 1986 p. 237). In other words we quickly decide whether or not
to trust the strangers with whom we come into contact. If we judge them to be disposed
not to do us harm we will trust in this minimal formulation. If we judge them neither
well nor ill disposed toward us we may still proceed although we are unlikely to trust
them, rather we may rely on their willingness to conform to the normal social
expectation of not unnecessarily interfering with us. If we judge them ill disposed
toward us then we may decide that to proceed is foolish and, if we have a choice in the
matter, abandon our intent. If, however, we judge that they have an ill will toward us
and we have no choice but to proceed then we can either hope that they will choose not
to harm us, or rely on systems of surveillance to prevent them from harming us. This
everyday experience of making rapid judgements about others’ intentions towards us is
something we take with us as patients. Under normal circumstances our initial
impressions of the relative trustworthiness of others is likely to be both incomplete and
in need of subsequent review as we Ieam more about those individual others. For as
Potter notes “When we want to determine whether or not to trust another with the care
of some good we value, we need to know what the other’s values, commitments, and
loyalties are” (Potter 2002 p. 7). In fact, if we have any choice in the matter at all, we
express some form Ofbackground trust by allowing ourselves to become patients in the
first place. Even if we have no choice and even if we believe we have good reason not
to trust nurses we must either rely on the systems of accountability (that is, trust in
institutions) that regulate nursing practice or merely hope that we will not be harmed by
untrustworthy nurses.
Professional trust relationships
Thus, trust and trustworthiness are important in health care in general and in nursing in
particular. This trust necessarily has elements of personal trust if nursing is conceived as
anything other a mere impersonal business-type arrangement but while some
similarities exist, nursing cannot be categorised as an example of personal trust. Some
instances of nursing practice may approximate personal trust because of the nature of
the interventions required in particular situations. I am thinking here of the therapeutic
relationships in some parts of nursing practice with persons suffering mental health
issues, or those within learning disabilities nursing where anecdotal reports of
friendships developed between nurses and service users are not uncommon. But these
instances arise as a result of an initial professional-client relationship and such
friendships as do develop, develop over and above this. Hence we might categorise trust
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