Chapter

The trustworthy clinician

Nancy Nyquist Potter

in Mapping the Edges and the In-between

Published on behalf of Oxford University Press

Published in print June 2009 | ISBN: 9780198530213
Published online February 2013 | e-ISBN: 9780191754388 | DOI: http://dx.doi.org/10.1093/med/9780198530213.003.0008

Series: International Perspectives in Philosophy & Psychiatry

The trustworthy clinician

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This framework for trustworthiness started with an assumption that those who trust hold certain expectations and make inferences about whom to trust, and those assumptions are, roughly, right for many of us. But some people's mental distress is such that their cognitive capacities are greatly diminished. Although trust is a relation –– and one where the act of trusting itself entails moral responsibilities of the trusted one –– not all relations of trust take this form. That is, a patient may have no choice but to place into a clinician's hands something the patient greatly values. Clinicians still need to be trustworthy to those patients, because their cognitive impairment exacerbates their vulnerability. Trustworthiness, in these situations, is more like being the sort of person who would be worthy of a given patient's trust if that patient were able to make choices about whom to trust. Our feelings and actions need to be appropriate for that context even when the patient is incapable of forming expectations about future predictability or assessing others’ good will. The relation of trust may look more like navigating upstream with no paddle partner. Yet one must travel responsibly, for both your sakes.

Chapter.  8992 words. 

Subjects: Psychiatry

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