Department of Philosophy and Moral Sciences, Bioethics Institute Ghent & Metamedica, Ghent University, Ghent, Belgium.
Bioethics. 2022 Oct;36(8):849-857. doi: 10.1111/bioe.13064. Epub 2022 Jun 9.
The centrality of trust in traditional doctor-patient relationships has been criticized as inordinately paternalistic, yet in today's discussions about medical ethics-mostly in response to disruptive innovation in healthcare-trust reappears as an asset to enable empowerment. To turn away from paternalistic trust-based doctor-patient relationships and to arrive at an empowerment-based medical model, increasing reference is made to the importance of nurturing trust in technologies that are supposed to bring that empowerment. In this article we stimulate discussion about why the move towards patient empowerment may not be able to keep clear of the criticism of trust in traditional patient-doctor relationships. First, we explore how such a shift in trust dynamics might corrode patient empowerment in the name of patient empowerment. Second, we examine how a translocation of trust may at best push the "trust issue" elsewhere and at worst make it harder to evaluate trustworthiness.
传统医患关系中信任的核心地位被批评为过度家长式作风,但在当今关于医学伦理的讨论中——主要是针对医疗保健领域的颠覆性创新——信任再次被视为一种使赋权成为可能的资产。为了摆脱基于家长式信任的医患关系,建立基于赋权的医疗模式,人们越来越多地提到信任技术的重要性,这些技术应该能够带来这种赋权。在本文中,我们探讨了为什么向患者赋权的转变可能无法避免传统医患关系中信任问题的批评。首先,我们探讨了这种信任动态的转变如何以患者赋权的名义侵蚀患者赋权。其次,我们研究了信任的转移如何在最好的情况下将“信任问题”推到其他地方,而在最坏的情况下使评估可信度变得更加困难。