Sheikh Zainab, Hoeyer Klaus
Department of Public Health, Centre for Medical Science and Technology Studies, University of Copenhagen, Oester Farimagsgade 5, 1014, Copenhagen K, Denmark.
Med Health Care Philos. 2018 Jun;21(2):169-179. doi: 10.1007/s11019-017-9795-9.
Trust features prominently in a number of policy documents that have been issued in recent years to facilitate data sharing and international collaboration in medical research. However, it often remains unclear what is meant by 'trust'. By exploring a concrete international collaboration between Denmark and Pakistan, we develop a way of unpacking trust that shifts focus from what trust 'is' to what people invest in relationships and what references to trust do for them in these relationships. Based on interviews in both Pakistan and Denmark with people who provide blood samples and health data for the same laboratory, we find that when participants discuss trust they are trying to shape their relationship to researchers while simultaneously communicating important hopes, fears and expectations. The types of trust people talk about are never unconditional, but involve awareness of uncertainties and risks. There are different things at stake for people in different contexts, and therefore it is not the same to trust researchers in Pakistan as it is in Denmark, even when participants donate to the same laboratory. We conclude that casual references to 'trust' in policy documents risk glossing over important local differences and contribute to a de-politicization of basic inequalities in access to healthcare.
信任在近年来发布的一些政策文件中占据显著地位，这些文件旨在促进医学研究中的数据共享和国际合作。然而，“信任”的含义往往仍不明确。通过探讨丹麦和巴基斯坦之间的一项具体国际合作，我们开发出一种剖析信任的方法，将重点从信任“是什么”转移到人们在关系中投入了什么，以及在这些关系中提及信任对他们有什么作用。基于在巴基斯坦和丹麦对为同一实验室提供血样和健康数据的人员进行的访谈，我们发现，当参与者讨论信任时，他们试图塑造自己与研究人员的关系，同时传达重要的希望、恐惧和期望。人们所谈论的信任类型绝非无条件的，而是涉及对不确定性和风险的认知。在不同背景下，人们面临的利害关系各不相同，因此，即使参与者向同一实验室捐赠，在巴基斯坦信任研究人员与在丹麦信任研究人员也是不一样的。我们得出结论，政策文件中对“信任”的随意提及可能会掩盖重要的地方差异，并导致医疗保健获取方面基本不平等的去政治化。
