phenomenon. Central to the various claims of psychology is the idea that trust is an
attitude of mind, a feature of the psyche, an attribute of an individual nature; whereas
sociological descriptions tend to emphasise trust as some form of social contract. By
and large, both disciplines assume trust involves competent adults able to engage as
equal contributors to the construction of, respectively, individual or social relationships.
In addition, there is a literature in philosophy some of which begins to recognise the
significance of the power differentials between individuals in many trust relationships.
Where trust is a matter for discussion in the nursing (and in the other health and social
care professions) literature these discussions tend to demonstrate allegiance to either
psychological or sociological traditions.
Typically those who enter the debate on the nature of trust become embroiled in
attempts to distance the idea of trust from the ideas of, for example, hope, faith,
confidence, belief and reliance. Yet defining trust invariably requires the use of those
same terms. This suggests inter alia that the nature of trust is such as to make the
disaggregation project difficult. This is not to say that the attempts are futile for
discussion provides a reminder of the important issues within matters of trust and the
related ideas of hope, faith, confidence, belief and reliance. So while it is a requirement
for Baier that trust involves the belief that others have a good will towards one (and for
her this is what distinguishes it from mere reliance), O’Neill notes that we “Sometimes
... know that good will is lacking, and yet we trust” (O’Neill 2002 p. 14), illustrating
the point by noting that “A patient may know a doctor finds him particularly irritating
and bears him little good will, and yet trust the doctor to exercise proper professional
judgement” (ibid). It is not clear whether what O’Neill describes here is trust or
reliance. The patient might not believe the doctor has a good will towards him but may
still trust the doctor to act professionally (what Seligman (1997) describes as ‘systems
trust’). Alternatively the patient may not trust the doctor in any sense but merely rely on
him because there is no other choice - in this respect reliance begins to look rather like
hope. Presumably, Baier would say that O’Neill’s example is simply a case of reliance;
that the patient is unable to trust and therefore has no choice but to rely upon the
doctor’s professionalism, or (in O’Neill’s terms) upon systems of accountability set up
to ensure patients are treated fairly regardless of the personal feelings of physicians.
Thus what we can recognise in these disagreements is not necessarily disagreements
about the essence of trust, but rather disagreement about distinctions between trust and
reliance.
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