Philosophical Perspectives on Trustworthiness and Open-mindedness as Professional Virtues for the Practice of Nursing: Implications for he Moral Education of Nurses

CHAPTER 4

TRUST AND TRUSTWORTHINESS

Most of us notice a given form of trust most easily after its sudden demise or
severe injury. We inhabit a climate of trust as we inhabit an atmosphere and
notice it as we notice air, only when it becomes scarce or polluted (Baier 1986
p. 234)

As suggested at the end of Chapter 3, it is a general expectation that patients should be
able to trust nurses (and other health and social care professionals) and this idea is given
formal expression in the nurses’ code of professional conduct (NMC 2004b). It might
then come as something of a surprise to find that the literature on trust and
trustworthiness is sparse. This suggests a general view that there are few, if any,
problems relating to trust and trustworthiness.

However, in such literature on trust and trustworthiness as exists, there are some who
believe otherwise. It may be that rather than suggestive of being Uncontentious or
unproblematic, the paucity of literature reflects a general failure to recognise problems
associated with being trustworthy, particularly in professional life. Also, despite its
significance for the moral life of persons, trust has received relatively scant attention
from philosophers in general and from moral philosophers in particular. As Baier (1986)
points out one feature of existing accounts is the tendency to dwell almost exclusively
on trust as something that occurs between rational adults. This failure of perspective
limits discussions of trust for the most part to relationships between competent adults.
On these accounts individuals whose rational capacities are compromised or
diminished, or who are otherwise unable to express their autonomy would appear to be
excluded. The conceptions of trust that claim trust is solely a matter of contractual
agreement(s) between equally autonomous adults will struggle to account for some
aspects of everyday experiences of trust. Trust invariably involves persons at different
times and in different ways throughout their lives and involves them, moreover, when
they are sometimes more and sometimes less autonomous, sometimes more and
sometimes less dependent, sometimes more and sometimes less powerful, and
sometimes more and sometimes less vulnerable.

Everyday understandings of trust can account for these variations in capacities in ways
that some philosophical, sociological and psychological accounts cannot. Attempts to

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