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Vulnerability and Trustworthiness

Polestars of Professionalism in Healthcare

Published online by Cambridge University Press:  09 March 2016

DAVID BARNARD
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Abstract:

Although recent literature on professionalism in healthcare abounds in recommended character traits, attitudes, or behaviors, with a few exceptions, the recommendations are untethered to any serious consideration of the contours and ethical demands of the healing relationship. This article offers an approach based on the professional’s commitment to trustworthiness in response to the vulnerability of those seeking professional help. Because our willingness and ability to trust health professionals or healthcare institutions are affected by our personality, culture, race, age, prior experiences with illness and healthcare, and socioeconomic and political circumstances—“the social determinants of trust”—the attitudes and behaviors that actually do gain trust are patient and context specific. Therefore, in addition to the commitment to cultivating attitudes and behaviors that embody trustworthiness, professionalism also includes the commitment to actually gaining a patient’s or family’s trust by learning, through individualized dialogue, which conditions would win their justified trust, given their particular history and social situation.

Keywords

professionalismhealing relationshipvulnerabilitytrusttrustworthinesssocial determinants
Type
Departments and Columns
Information
Cambridge Quarterly of Healthcare Ethics , Volume 25 , Issue 2 , April 2016 , pp. 288 - 300
Copyright
Copyright © Cambridge University Press 2016 

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References

Notes

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41. The structural conditions affecting patients’ or communities’ trust are not the only factors largely outside the individual practitioner’s immediate control. The institutional environment within which the practitioner works—its policies, procedures, and general atmosphere, which can be more or less welcoming or intimidating, agency-enhancing or agency-sapping, for patients and families—is also likely to affect trust. Additional constraints on professional behavior with patients and families with likely influence on the practitioner’s ability to gain their trust come from institutional approaches to practice management, e.g., expectations regarding practitioner workload and patient volume, management surveillance, and pay-for-performance measures. Some of these issues have been discussed under the heading of “organizational professionalism”; see, e.g., Egener, B, McDonald, W, Rosof, B, Gullen, D. Organizational professionalism: Relevant competencies and behaviors. Academic Medicine 2012;87(5):668–74.CrossRefGoogle ScholarPubMed

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