J Med Ethics. 2019 Nov;45(11):746-747. doi: 10.1136/medethics-2018-105257. Epub 2019 Jul 18.
In their paper 'Too much medicine: not enough trust?' Zoë Fritz and Richard Holton explore the connection between trust and overtreatment and overinvestigation. Whilst their paper is insightful, here I argue that much more could be made of a doctor's (mis)trust and how this exacerbates overtreatment and overinvestigation. By taking Fritz and Holton's view of trust as having 'our best interests at heart' as my starting point, I argue that doctor's do not always trust that patients or the system has their interests at heart and so use overtreatment and overinvestigation to protect themselves. I also point to the tensions created by a lack of trust on the doctor's part as a focal point for much needed sustained ethical analysis.
在他们的论文《过度医疗：缺乏信任？》中，Zoë Fritz 和 Richard Holton 探讨了信任与过度治疗和过度检查之间的联系。虽然他们的论文具有深刻的见解，但在这里，我认为可以更多地探讨医生的（缺乏）信任以及这种信任如何加剧过度治疗和过度检查。以 Fritz 和 Holton 将信任视为“将我们的最佳利益放在心上”作为我的起点，我认为医生并不总是相信患者或系统会将他们的利益放在心上，因此会使用过度治疗和过度检查来保护自己。我还指出，由于缺乏信任，医生方面会产生紧张局势，这是非常需要进行持续伦理分析的焦点。
