E-DRUG: trust

["Billy Futter" <B.Futter@ru.ac.za>]

E-DRUG: trust
-------------

Fellow E-druggers

Ngoyi has raised some very interesting propositions to test as 
follows: 

- (1) a great deal of trust (or ignorance) on the patient's side is
the preferred way of doing business in the provision of 
pharmaceutical care; 

- (2) one can more or less freely manipulate the level of trust (and
ignorance) on the patient's side. Such a manipulation is feasible 
more so now than it used to be in the past.

- (3) pharmaceutical care providers are less likely or less inclined
to abuse their patients, and 

- (4)  health outcomes are more likely to be improved  by
pharmaceutical care providers when they operate under the veil of
blind trust from their clients.

Specifically, he has asked for empirical evidence to support or 
reject them.  This would enable us to move out of the realm of 
speculation about what "should be" to "what is" - the age old 
positive/ normative dichotomy.  I cannot provide the evidence which 
he seeks.  

However, I would like to raise the issue of what is meant by "trust". 
In this context I suggest that it would mean a belief that a person 
(or advice) is reliable, honest, truthful, caring, competent, providing 
confidentiality, committed to one's care.  These are the qualities 
that a health care professional would be expected to exhibit.  
Society empowers (gives trust) to these professionals to make 
decisions on its behalf because society does not understand the 
complex decisions that professionals have to make about health.  
Professionals are empowered because they commit themselves to 
caring for society's needs.  Professionals who behave in a way 
which undermines the trust of society find themselves 
disempowered by ethical bodies set up to look after the interests of 
society. An individual is able to increase the level of trust by 
exhibiting expertise and through charisma.  However, charisma 
without care and expertise soon tarnishes. 

Back to Ngoyi's points - patients are ignorant and have no 
alternative but to trust health care providers.  Health care providers 
who exploit this trust will eventually lose their priveleged status, 
either through superior competitors, inability to provide the 
outcomes they claim, or through being disempowered by the local 
community or national/ regional watchdogs. 

Billy

Billy Futter
Associate Professor
Faculty of Pharmacy
Rhodes University, Grahamstown, South Africa
email B.Futter@ru.ac.za

 
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