Based on two years’ ethnographic research on doctor-patient relations in urban China, this paper examines the causes of patients’ mistrust of physicians. I identify the major factors at the societal, institutional, and interpersonal levels that lead to patients’ mistrust of physicians. First, I set the context by describing the extent of mistrust at the societal level. Then, I investigate the institutional sources of mistrust. I argue that the financing mechanism of public hospitals and physicians’ income structures (...) are the most crucial factors in inducing patients’ mistrust. Hospitals’ heavy reliance on self-finance has basically caused public hospitals to run like private hospitals, resulting in blatant conflicts of interest between hospitals and patients. Related to this is physicians’ reliance on bonuses and commissions as part of their regular incomes, which has inevitably resulted in overtreatment and, hence, mistrust from the patients. At the interpersonal level, I describe how individual physicians’ attitudes toward and interaction with patients may also affect patients’ sense of trust or mistrust in physicians. In conclusion, I discuss the ethical implications of the mistrust problem, and suggest changes at the institutional and interpersonal levels to mitigate the problem. (shrink)

In this essay, I argue that exploring institutional racism also needs to examine interactions and communications between patients and providers. Exchange between bioethicists, social scientists, and life scientists should emphasize the biological effects—made evident through health disparities—of racism. I discuss this through examples of patient–provider communication in fertility clinics in South Africa and the ongoing COVID-19 pandemic to emphasize the issue of mistrust between patients and medical institutions. Health disparities and medical mistrust are interrelated problems of racism in (...) healthcare provision. (shrink)

As the USA contends with another surge in COVID-19 cases, hospitals may soon need to answer the unresolved question of who lives and dies when ventilator demand exceeds supply. Although most triage policies in the USA have seemingly converged on the use of clinical need and benefit as primary criteria for prioritisation, significant differences exist between institutions in how to assign priority to patients with identical medical prognoses: the so-called ‘tie-breaker’ situations. In particular, one’s status as a frontline healthcare worker (...) (HCW) has been a proposed criterion for prioritisation in the event of a tie. This article outlines two major grounds for reconsidering HCW prioritisation. The first recognises trust as an indispensable element of clinical care and mistrust as a hindrance to any public health strategy against the virus, thus raising concerns about the outward appearance of favouritism. The second considers the ways in which proponents of HCW prioritisation deviate from the very ‘ethics frameworks’ that often preface triage policies and serve to guide resource allocation—a rhetorical strategy that may undermine the very ethical foundations on which triage policies stand. By appealing to trust and consistency, we re-examine existing arguments in favour of HCW prioritisation and provide a more tenable justification for adjudicating on tie-breaker events during crisis standards of care. (shrink)

In this chapter I explore some of the roles of trust, mistrust, and distrust in deeply plural or diverse societies. Section One sets out the features of deeply diverse societies that provide the contexts of trust and distrust. Section Two proposes that social relationships in diverse societies need to have two qualities to be full of intersubjective trust (trustful) and, thus, worthy of trust (trustworthy) of the members of the relationships: cooperative and contestatory quality, and self-sustaining and co-sustaining quality. (...) Section Three suggests that such trustful relationships are grounded in and draw on a second type of trust: pre-existing co-operational trust. Section Four argues that trustful relationships and co-operational trust are co-sustained by a third type of trust: an interactive ethics or ethos of trust of the members within which they exercise judgements of trust and mistrust. These three types of trust form a triad that sustains virtuous (autopoietic) systems of trust and peacefulness (nonviolence). Throughout the sections the features of virtuous systems of trust are contrasted with vicious systems of distrust. (shrink)

Vaccination is considered a key factor in the sanitary resolution of the COVID-19 pandemic. However, vaccine hesitancy can undermine its diffusion with severe consequences on global health. While beliefs in conspiracy theories, mistrust in science and in policymakers, and mistrust in official information channels may also increment vaccine hesitancy, understanding their psychological causes could improve our capacity to respond to the pandemic. Thus, we designed a cross-sectional study with the aim of probing vaccine propensity in the Italian population (...) and explored its relationship with sociodemographic and psychological variables, and with misbeliefs in COVID-19. A battery of questionnaires was administered to a sample of 374 Italian adults during the first national lockdown. The materials included an original instrument—Beliefs in COVID-19 Inventory—and questionnaires measuring perceived stress, anxiety, death anxiety, psychological distress, psychoticism, paranoia, anger, and somatization. The exploratory factor analysis on Beliefs in COVID-19 suggested the existence of three factors: belief in conspiracy theories, mistrust in medical information, and mistrust in medicine and science. These factors were positively correlated with female sex, age, religious beliefs, psychiatric conditions, and psychological variables, while negatively correlated with education levels. We conducted a mediation analysis by means of a structural equation model, including psychological factors as predictors, beliefs in COVID-19 scales as mediators, and vaccine propensity as an outcome. The model showed that death anxiety had a direct positive effect on the propensity to get vaccinated. It also showed that death anxiety reduced the propensity to get vaccinated through a mediated path in believing in conspiracy theories, whereas paranoia was linked to a reduction in vaccination adherence with the mediation effect of mistrust in medical science. Psychological distress reduced vaccination propensity by increasing both conspiracy beliefs and mistrust. On the other hand, anxiety increased the propensity to get vaccinated through a decrease in both belief in conspiracy theories and mistrust in science. Our results suggest that psychological dimensions are differentially related to belief in conspiracy theories, to mistrust in science, and to the propensity to get vaccinated. Based on this result, we propose an original interpretation of how conspiracy beliefs build on a paranoid and suspicious attitude. We also discuss the possible clinical implications of treatment for such pathological beliefs. (shrink)

This article aims to contribute to healthcare communication literature by providing factors that result in mistrust and miscommunication for Deaf people. Deaf people experience a lot of health inequity, which can be, in large part, attributed to being a result of communication and misunderstanding between Deaf people and healthcare staff, resulting in mistrust. Presenting outcomes of practical experiments as well as theoretical reasons for the misunderstanding and mistrust allows to make suggestions about how to improve communication for (...) the future. This review can serve as guidance for factors that contribute to miscommunication that should be avoided by healthcare staff and for lessons learned from positive experiences that should be scaled up and applied to ensure more clear and supportive communication. (shrink)

In this paper I explore the politics of trust in the clinical testing of pharmaceuticals in the US. Specifically, I analyze trust in terms of its institutional manifestations in the pharmaceutical clinical trials industry. In the process of testing new drugs, pharmaceutical companies must (1) protect their proprietary information from the clinicians who conduct their studies, and (2) find a way to ensure human subjects’ compliance to study protocols. Concern with these two critical issues leads drug companies to approach clinicians (...) and research subjects with an attitude of mistrust and the desire to exert control over their activities. This orientation results in an institutionalization of mistrust that structures the relationships and activities required for the clinical development of new pharmaceutical products. (shrink)

This paper characterizes the crisis of expertise, especially as it manifested during the covid-19 pandemic, as a crisis of trust in regulatory science. The temporal structure of the facts produced by regulatory science differs from Kuhnian “normal science,” while they also contain profound distributional implications. As a result, they suffer from a set of congenital problems that provoke mistrust in a way that normal science facts do not. While “expertise” is often offered as an answer to these problems, the (...) paper shows that it is a symptom of the malaise, reflecting a situation where it is no longer clear how to decide between competing claims to authority as experts. The current mistrust in experts and regulatory science during the pandemic, therefore, is part of a longer and systemic crisis of expertise provoked and sustained by multiple factors. The paper then offers an unsystematic set of rules of method to observe when addressing the thorny issues involving trust and mistrust: 1) trust is not a subjective attitude that can be measured by a survey; 2) mistrust is not the opposite of trust; 3) trust is a social skill involving a set of ethnomethods for distinguishing between responsible and “blind” trust; 4) attention to temporal framing is key to these methods; 5) disruption of this temporal framing – as routinely happens with regulatory facts, and especially during the pandemic – destroys trust. (shrink)

Nietzsche talks about trust [vertraue*] and mistrust [misstrau*] in all of his published and authorized works, from The Birth of Tragedy to Ecce Homo. He refers to trust in 90 passages and mistrust in 101 – approximately ten times as often as he refers to resentment/ressentiment. Yet the scholarly literature on Nietzsche and trust includes just a handful of publications. Worse still, I have been unable to find a single publication devoted to Nietzsche and mistrust. This chapter (...) aims to fill the gap in the secondary literature by using digital humanities methods to systematically investigate the functions of trust and mistrust in Nietzsche’s writings. I argue that Nietzsche offers three main insights into trust and an additional two into mistrust. When it comes to trust, in his free spirit works, he reflects on the development of interpersonal trust, with an eye to situations in which trust is or is not reciprocated. He also criticizes some of the heuristics people use to identify trustworthy partners, especially the notion that all and only people with stable character are trustworthy. And perhaps Nietzsche’s most interesting thoughts about trust relate to self-trust, which he thinks is often unjustifiably undermined. When it comes to mistrust, although he regards generalized mistrust as a sign of bad character, he also thinks that harnessing mistrust can be valuable in at least two domains. One is morality, where we are disposed to accept traditional pieties and would benefit from turning a suspicious eye towards these pieties. The other is science, which systematizes both trust and mistrust in pursuit of the truth. (shrink)

Recent studies show that racism still exists in the American medical profession, the fact of which legitimizes the historically long-legacy of mistrust towards medical profession and health authorities among African Americans. Thus, it was suspected that the participation of black patients in end-of-life care has always been significantly low stemmed primarily from their mistrust of the medical profession. On the other hand, much research finds that there are other reasons than the mistrust which makes African Americans feel (...) reluctant to the end-of-life care, such as cultural-religious difference and genuine misunderstanding of the services. If so, two crucial questions are raised. One is how pervasive or significant the mistrust is, compared to the other factors, when they opt out of the end-of-life care. The other is if there is a remedy or solution to the seemingly broken relationship. While no studies available answer these questions, we have conducted an experiment to explore them. The research was performed at two Philadelphia hospitals of Mercy Health System, and the result shows that Black patients’ mistrust is not too great to overcome and that education can remove the epistemic obstacles as well as overcome the mistrust. (shrink)

The effectiveness of vaccination programmes depends on high levels of public trust in political, scientific and health-related institutions, but public trust in vaccines can waver. This article explores aspects of public trust and mistrust on a web media platform about the MMR (measles-mumps-rubella) vaccine through the statements of a doctor and an anonymised ‘anti-vaxxer’. Thematic analysis identifies commonalities and divergences in both perspectives. Both trust and mistrust of MMR vaccination are presented as moral, reasoned stances by their proponents; (...) they are connected to the individual’s experiences and situations, but are associated with very different trust attitudes to scientific and political institutions. Moreover, both the trustworthiness of the speakers themselves and the (un)trustworthiness of authorities are emphasised. Trust and mistrust are also thematised in relation to contextual matters such as the role of social media and the historical MMR controversy. Further research towards identifying common ground between trust positions is recommended. (shrink)

The use of foster children as subjects in the pediatric HIV/AIDS clinical trials has been the subject of media controversy, raising a range of ethical and social dimensions. Several unsettled issues and debates in research ethics underlie the controversy and the lack of consensus among professional researchers on these issues was neither adequately appreciated nor presented in media reports. These issues include (1) the tension between protecting subjects from research risk while allowing them access to the possible benefits of research; (...) (2) the blurring of the potentially conflicting roles of investigator and physician and the boundaries between research and therapy; (3) the adequacy of Institutional Review Board oversight; and (4) trust and the relationships among physicians, investigators and industry. The media controversy about the pediatric HIV/AIDS clinical trials can be seen as a means of “manufacturing mistrust” in health care, research and social services that have not always met the needs and expectations of the public. In an era of emerging infections, it is critical to the public’s health that people understand the role of rigorous and ethical research in the development of safe and effective care. Investigators, journalists and the public need to become knowledgeable about major ethical issues in the conduct of research in order to engage in dialogue about balancing research risks and benefits and to be able to distinguish fact from distortion in an era of multiple and rapid transmission of information. (shrink)

Is autonomy – governing yourself – compatible with letting yourself be governed by trust? This paper argues that autonomy is not only compatible with appropriate trust but actually requires it. Autonomy requires appropriate trust because it is undermined by inappropriate mistrust. An autonomous agent treats herself as answerable for her action-guiding commitments, where answerability requires openness to the rational influence of external, critical perspectives on those commitments. This openness to correction makes one vulnerable to manipulation and can be exploited (...) in ways that undermine autonomy instead of supporting it. We argue that autonomy is undermined by inappropriate trust, and that the inappropriateness lies in the agent’s failure to manifest appropriate responsiveness to evidence of untrustworthiness in the one trusted. The problem isn’t that autonomy requires dispensing with trust but that trust must itself be governed by appropriate responsiveness to evidence of untrustworthiness. Our view confronts two challenges. One challenge lies in explaining why you shouldn’t treat your vulnerability to manipulation as a general reason to let your trusting disposition lapse into an untrusting one. We argue that there is no such general reason to let your responsiveness to evidence of untrustworthiness be supplanted by a suspicious disposition to seek and require positive evidence of trustworthiness. A second, and deeper, challenge arises from the fact that in some especially sophisticated cases of manipulation there is no evidence of untrustworthiness to which you could respond. We argue that you cannot rationally cope with even this unresolvable risk of exploited trust by trusting only yourself. (shrink)

Bioethics, Volume 36, Issue 3, Page 267-273, March 2022.

In the ethics of algorithms, a specifically epistemological analysis is rarely undertaken in order to gain a critique (or a defense) of the handling of or trust in medical black box algorithms (BBAs). This article aims to begin to fill this research gap. Specifically, the thesis is examined according to which such algorithms are regarded as epistemic authorities (EAs) and that the results of a medical algorithm must completely replace other convictions that patients have (preemptionism). If this were true, it (...) would be a reason to distrust medical BBAs. First, the author describes what EAs are and why BBAs can be considered EAs. Then, preemptionism will be outlined and criticized as an answer to the question of how to deal with an EA. The discussion leads to some requirements for dealing with a BBA as an EA. (shrink)

Hastings Center Report, Volume 52, Issue 2, Page 3-3, March‐April 2022.

The importance of research on the notion of trust has grown considerably in the social sciences over the last three decades. Much has been said about the decline of political trust in democracies and intense debates have occurred about the nature and complexity of the relationship between trust and democracy. Political trust is usually understood as trust in political institutions, trust between citizens, and to a lesser extent, trust between groups. However, the literature on trust has given no special attention (...) to the issue of trust between minority and majority nations in multinational democracies – countries that are not only multicultural but also constitutional associations containing two or more nations or peoples whose members claim to be self-governing and have the right of self-determination. This volume, part of the work of the Groupe de recherche sur les sociétés plurinationales, is a comparative study of trust, distrust, and mistrust in multinational democracies, centring on Canada, Belgium, Spain, and the United Kingdom. Beliefs, attitudes, practices, and relations of trust, distrust, and mistrust are studied as situated, interacting, and coexisting phenomena that change over time and space. Contributors include Dario Castiglione, Jérôme Couture, Kris Deschouwer, Jean Leclair, Patti Tamara Lenard, Niels Morsink, Geneviève Nootens, Darren O’Toole, Alexandre Pelletier, Réjean Pelletier, Philip Resnick, David Robichaud, Peter Russell, Richard Simeon, Dave Sinardet, and Jeremy Webber. (shrink)

This essay argues that the success of «post-truth» is partially connected to the characteristics of the new «hybrid» communication scenario. The author maintains that the current context differs substantially from the _democracy of parties_, which has characterised a part of the 20 th century, as well as from the _democracy of the public_, a notion formulated by Bernard Manin in the mid-1990s. As a matter of fact, the diffusion of the new media has triggered the fragmentation of _the public_ into (...) a plurality of self-referential segments and «bubbles» which are (potentially) not rooted in an intersubjective sphere of communication. Considering the impact of these transformations, the essay proposes the image of a _bubble democracy_ as an alternative to the mainstream interpretations both of the _democracy of parties _and of the _democracy of the public_ and it argues that its main features are the widespread mistrust towards institutions, audience fragmentation and polarisation. (shrink)

Long portrayed as a virtuous profession, teaching has always been embedded in notions of trust and trustworthiness. Alongside expectations of epistemic cultivation and development, is an implicit handing over of discretionary powers to ‘the trusted teacher’. At the height of #blacklivesmatter protests in 2020, however, high school learners all over South Africa took to social media—@yousilenceweamplify—to express their hurt and anger at their dehumanising experiences at some of the country’s leading schools. Their accounts not only exposed some schools as intense (...) sites of racial, religious, cultural, ethnic, and linguistic tension and conflict, but shattered presumptions about ‘the trusted teacher’. Following a consideration of what trust infers, and the potential harms that arise from epistemic mistrust, the paper considers what might be gained from philosophical engagements in the espousal of teaching as a relationship of epistemic trust, and which ensures the flourishing of both learner and teacher? How might philosophy of education assist teacher education programmes in attuning students to an understanding that being trustworthy as teachers resides in self-knowledge as well as knowledge of the differences of, and among others? (shrink)

To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust leads to increased levels of fear and self-protection by doctors (...) which exacerbate difficulties in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. (shrink)

A discussion with Bernard Williams about main themes in his work. (Note: a version of this interview appears in 'Conversations on Ethics' (OUP, 2009).).

Can one mistrust one's own belief? Wittgenstein says ‘No.’ He remarks: ‘One can mistrust one's own senses, but not one's own belief.’It is natural to think that this is not meant merely as a remark about our psychological abilities or inabilities; viz., that one can not, as a matter of psychological fact, help but trust one's own belief. Rather, one is inclined to take it as a ‘grammatical remark’ to the effect that it makes no sense to speak (...) of trusting or mistrusting one's own belief. (shrink)

We reject the concept of a default option of withdrawal as proposed by Syltern and colleagues, and will outline here potential consequences on parental trust, particularly in historically marginali...

Purpose The study explores how social media impacts institutional trust through the lens of Kohlberg’s stages of moral development. Specifically, this study aims to understand how moral relativism and moral intuitionism can moderate the relationship between social media use and perception of social authorities. Design/methodology/approach The study analyzes a large data set from the World Values Survey, covering responses from approximately 52,000 individuals across 45 countries between 2017 and 2022. Multiple regression analyses were conducted to test for interactions between social (...) media use and stages of moral development on trust in social institutions. Findings The study finds that different stages of moral development significantly moderate the relationship between social media use and institutional trust. Specifically, higher moral development buffers the negative effect of social media use on trust in three main social institutions: law enforcement, parliament and the legal system. In contrast, individuals with higher levels of moral relativism and moral intuitionism are more susceptible to the negative influence of social media on institutional trust. Research limitations/implications The study relies on self-reported data from the World Values Survey, which may introduce response biases. In addition, while the large-scale data set offers insights into correlations, it does not allow for conclusive causal inferences. Originality/value This research contributes to understanding technology’s impact on modern societies by highlighting the role of individual moral development in shaping perceptions of key social institutions. The study uniquely integrates Kohlberg’s moral development theory with the influence of social media, offering a novel perspective on how personal moral systems can moderate the effect of digital media use. (shrink)

Focusing on the shared sense of victimization and disadvantage-ness by both patients and doctors/medical workers in cases of medical conflicts, this paper aims to examine the current patient-doctor tensions in the larger context of moral transformation in Chinese society since the 1980s. Although the decline of public trust in certain aspects is closely associated with the impact of commodification and commercialization of medical sector during the past two decades, other factors play important role as well. In the case of patient-doctor (...) tension, mutual disrespect and mistrust also result from the ongoing process of individualization and the remaking of moral self, in which the individual demand for respect, dignity, and trust seem to have unexpectedly and ironically contributed to the rise of tensions and conflicts between patients and doctors as well as other medical workers. (shrink)

In ‘The ethics of consent during labour and birth: episiotomies,’ van der Pijl et al 1 respond to the prevalence of unconsented procedures during labour, proposing a set of necessary features for adequate consent to episiotomy. Their model emphasises information sharing, value exploration and trust between a pregnant person and their healthcare provider(s). While focused on consent to episiotomy, van der Pijl et al contend their approach may be applicable to consent for other procedures during labour and beyond pregnancy-related care. (...) One feature of their model for adequate informed consent is trust in the systems in which prenatal and labour and delivery care are provided. Yet, for some pregnant persons, mistrust in health systems is a reasonable sequela of experiences like racism and epistemic injustice. For a programme in which trust is central to adequate consent, it is important to identify—and counter—forms of mistrust toward pregnant persons within healthcare and acknowledge and rectify reasonable mistrust of pregnant persons toward healthcare. Like other kinds of healthcare disparities, van der Pijl et al note that ‘the burden of unconsented procedures is not evenly distributed over groups’ and tracks with ‘racial, socioeconomic and other disparities in maternity care’. They are drawing on data from a less diverse context than the one …. (shrink)

The standard, non‐repeated prisoner's dilemma poses no true dilemma about rationality, we argue. What the prisoners ought rationally to do, unless they are selfless, depends on the relationship of trust that they have or lack with one another. This helps to diffuse the apparent conflict between individual and collective rationality. If the prisoners have reason to trust one another, pursuing a joint strategy would be rational for them. In the absence of trust, pursuing an individual strategy would be rational. The (...) solution that is supposed to be puzzling – because each prisoner confessing is worse for both than the alternative on which both remain silent – is simply the rational solution for persons who have no reason to trust one another. Philosophers have been misled by the apparent availability of the better alternative. Collective rationality is not relevant for persons who do not stand in a trusting relationship. When they do, there is no unresolved conflict between their individual and collective points of view.1. (shrink)

The COVID‐19 pandemic has shaken the world through its first wave, and we have yet to experience the second wave. Even resourceful countries have failed to adequately prevent epidemics in their country, and for countries like Bangladesh, which already has strained an ineffective healthcare system, the challenges to contain the SARS‐CoV‐2 virus are that much more severe. Due to the scarcity of resources and systematic failures the Bangladeshi people deeply mistrust the healthcare system. The mistrust is further magnified (...) as healthcare providers are hesitant to treat the patients because of the lack of proper protective gear. Physicians have a moral obligation to serve and treat patients; however, they have a moral obligation to protect their families. This dilemma places healthcare providers in situations where they experience moral distress. This article specifically discusses the importance of interpersonal relationships in driving change, using the framework of Responsiveness, while stating the need for complementary systematic change in order to rebuild trust in the Bangladeshi healthcare system. (shrink)

Rosamond Rhodes' evaluation of modern American research ethics emphasizes a need to shift from a protectionist understanding of human subjects to one that focuses more on the conduct of research in...

Purpose– The aim of this study is to examine interpersonal trust in Muslim matrimonial sites from a male perspective. Specifically how users perceive interpersonal trust in MMS; what are the signs of lack of trust in MMS ; and what strategies do users adopt to handle the lack of trust in MMS.Design/methodology/approach– This empirical qualitative study used ethnographic techniques to collect data. In addition to briefly observing five MMS, the study conducted semi-structured interviews with ten participants, who were all males, (...) between the ages of 25-35, and residing in different locations, including the USA, the UK, the UAE, Australia and Bahrain. While the interviews focused on participants' experience in MMS, the analysis of these interviews focused on the issue of trust in these sites.Findings– The analysis has revealed that participants associated trust with “risk taking”, “reliance” on one's abilities, “self-confidence” and honesty with the first three being the major themes that transpired from the analysis of data. The analysis has also revealed three signs of lack of trust in MMS. Users expressed concern over a large number of members' profiles being fake; they appeared suspicious about these sites and approached them with caution and felt intimidated by the unrealistic expectations members placed on them. However, it was found users adopted several strategies to handle the lack of trust in MMS including using their communication skills to study others carefully, doing “police work” to uncover any inconsistencies in their statements, “interrogating” them using a pre-developed list of questions and involving their family members in their negotiations.Originality/value– Despite MMS immense popularity within the Islamic world, with the exception of a few articles, there are not many articles available in the academic literature on them. This article seeks to address this imbalance. (shrink)

One issue that sometimes produces mistrust of God in the life of a Christian is God’s perceived silence when He allows a trial to enter the believer’s life—especially when the believer has been faithfully praying that God would not allow it and there is no evident reason why God would not answer this prayer. This paper examines the nature of trust and some key reasons why it is difficult to trust God. It then argues that accepting the truth of (...) human libertarian freedom and divine middle knowledge provides a powerful basis for thinking that God has meticulous providential control over the world without implicating God in evil, and this can help believers to trust God when they face trials and wrestle with His silence and apparent unresponsiveness to prayer. (shrink)

Since the emergence of Pakistan the history of Pak-Afghan relations can best be analyzed from conflict to cooperation. Some of the early problems are mainly responsible for conflict and cooperation in both countries relations. After the establishment of democratic setup in both states, different CBMs indicate positive sign in Pak-Afghan diplomatic relationship. The drawdown of US forces has created security concern for Pakistan and Afghanistan that the creation of power vacuum can push the country again into civil war like situation. (...) In such state of security Pakistan’s engagement to bring the Taliban to the negotiation table will smooth the way for a broad-based government in Afghanistan. Some of the Afghan domestic political issues also created mistrust i.e., the refugee’s problem, cross border militant’s infiltrations, drug problem and issue of the Taliban. However, the paper will highlight the measures to keep intact the reconciliation more effective and replace the mistrust by trust. How domestic political issues effect their bilateral relations and why various methods taken in the prescribe time not effective in bilateral relations of the two states. (shrink)

Social representations of addiction and the resulting stigmatization have been widely described and studied in the literature, but their effects are no less problematic. These representations, which also occur in care settings, generate a climate of distrust which damages the therapeutic relationship, and its ethical quality. This article, combining clinical experience and an ethical stance, offers an original, innovating approach to the existence of distrust in care relationships in the area of addiction. Pragmatic approaches deriving from the human sciences and (...) analytical philosophy provide an invitation to escape from the demanding climate of mistrust, and to take the gamble on trust so as to improve the quality of interactions between protagonists in care. In complementary fashion, a sociology of action can combat the disquiet generated by distrust through a new commitment to innovating forms of action. This “poetic” mode of action is legitimized by the reflection that backs it up, and by its presentation to peers qualified to approve it. Finally, continental moral philosophy underlines the importance of a carefully weighed commitment on the part of caregivers and addicted patients towards promises aiming to support a sincere care relationship, without damaging the therapeutic dynamic or the ethical quality by providing too many safety nets. This reflection is intended to achieve better identification of the clinical and ethical issues raised by mistrust, and inclusion of these aspects in the training of personnel and in care provision planning. (shrink)

The paper reflects on recent developments towards authoritarianism and right-wing populism that have become apparent in a number of Western societies and aims at pinpointing possible cultural foundations for this trend. Using the example of the German PEGIDA movement and the wider milieu in which it is embedded, it identifies and describes a rapidly spreading culture of mistrust and discusses some of its political and epistemological implications. In a second step, the paper draws on Luc Boltanski?s theory of justification (...) in order to attain a better understanding of this political movement?s specificities. It is argued that it is a quasi-violent refusal of justification which is constitutive for the movement in question, thereby transcending the reach of Boltanski?s framework to some extent. In a third step, a closer look is taken at the epistemological paradox that results from the fact that a number of the PEGIDA movement?s crucial points of criticism are effectively shared by a larger part of the overall population, raising severe problems for the question of sociological critique. The paper utilizes ideas by Bruno Latour in order to illuminate this paradox further and examine its consequences. It closes with remarks on the possibility to?reassemble? trust and critique as crucial but contested - and, hence, precarious - foundations of modern society. nema. (shrink)

This paper asks whether we should still be haunted by scepticism about other minds. It draws on the writings of Cavell and Husserl to show that there is some truth in the Cartesian premise that has given rise to scepticism about other minds, namely, that our self-awareness is of a fundamentally different type from our awareness of objects and other subjects. While this leads Cavell to argue that there is a truth to scepticism, it proves the opposite to Husserl, viz. (...) that other minds scepticism is necessarily non-sensical. The paper shows why Husserl's position is more convincing than Cavell's. 1. (shrink)

This study explored drug users’ attitudes toward and understanding of randomized controlled trials testing addiction therapies. A video portraying a fictional consent conference for a randomized controlled trial with placebo arm was shown to poor male and female drug users of diverse ethnic status and sexual orientation. The video stimulated focus group discussion in which participants’ comments often reflected “experimental realism”—a realistic view of the trial—and adequate understanding of the uncertain efficacy of the treatment being tested, as well as the (...) concepts of randomization and placebo control. However, participants’ comprehension of the nature of placebos was compromised by the widespread view that placebos are a way of testing a subject’s willpower and personal control over his or her addiction. Comments also showed a mistrust of the video investigator’s integrity and competence and signs of therapeutic misconception and misestimation. The study’s findings underscore the importance of tailoring informed consent encounters to the personal and sociohistorical context of participants’ lived experiences. (shrink)