6 - Differentiating Trust from Related Concepts

Summary

In most of the literature, trust is treated as a binary concept: either you trust or you do not trust. Here, the authors argue that this is wrong. Whereas the opposite of knowledge is ignorance, i.e. the absence of knowledge, the opposite of trust (a positive expectation) is not simply the absence of this positive expectation but a negative expectation (distrust). In between trust and distrust there is yet a third option: the suspension of trust (mistrust). To disregard this distinction has serious consequences: opinion polls ask people whether they trust doctors or not. If people answer ‘no’, it remains unclear whether they have suspended their trust or whether they harbour negative expectations. Belief-in, hope, reliance, and confidence are often used interchangeably with trust. This intermingling leads to misunderstanding, as several examples illustrate. Hence, it is mandatory that we distinguish these terms. As the authors demonstrate, this can be achieved by using pattern-based definitions of these related concepts. The chapter ends with a closer look at the role that these four often-conflated concepts play in the patient–physician relationship in separate subsections.