BackgroundCommunity engagement in research has gained momentum as an approach to improving research, to helping ensure that community concerns are taken into account, and to informing ethical decision-making when research is conducted in contexts of vulnerability. However, guidelines and scholarship regarding community engagement are arguably unsettled, making it difficult to implement and evaluate.DiscussionWe describe normative guidelines on community engagement that have been offered by national and international bodies in the context of HIV-related research, which set the stage for similar work (...) in other health related research. Next, we review the scholarly literature regarding community engagement, outlining the diverse ethical goals ascribed to it. We then discuss practical guidelines that have been issued regarding community engagement. There is a lack of consensus regarding the ethical goals and approaches for community engagement, and an associated lack of indicators and metrics for evaluating success in achieving stated goals. To address these gaps we outline a framework for developing indicators for evaluating the contribution of community engagement to ethical goals in health research.SummaryThere is a critical need to enhance efforts in evaluating community engagement to ensure that the work on the ground reflects the intentions expressed in the guidelines, and to investigate the contribution of specific community engagement practices for making research responsive to community needs and concerns. Evaluation mechanisms should be built into community engagement practices to guide best practices in community engagement and their replication across diverse health research settings. (shrink)

How can mental properties bring about physical effects, as they seem to do, given that the physical realizers of the mental goings-on are already sufficient to cause these effects? This question gives rise to the problem of mental causation (MC) and its associated threats of causal overdetermination, mental causal exclusion, and mental causal irrelevance. Some (e.g., Cynthia and Graham Macdonald, and Stephen Yablo) have suggested that understanding mental-physical realization in terms of the determinable/determinate relation (henceforth, 'determination') provides the key to (...) solving the problem of MC: if mental properties are determinables of their physical realizers, then (since determinables and determinates are distinct, yet don't causally compete) all three threats may be avoided. Not everyone agrees that determination can do this good work, however. Some (e.g., Douglas Ehring, Eric Funkhauser, and Sven Walter) object that mental-physical realization can't be determination, since such realization lacks one or other characteristic feature of determination. I argue that on a proper understanding of the features of determination key to solving the problem of MC these arguments can be resisted. (shrink)

The actions performed by individuals, as consumers and citizens, have aggregate negative consequences for the environment. The question asked in this paper is to what extent it is reasonable to hold individuals and institutions responsible for environmental problems. A distinction is made between backward-looking and forward-looking responsibility. Previously, individuals were not seen as being responsible for environmental problems, but an idea that is now sometimes implicitly or explicitly embraced in the public debate on environmental problems is that individuals are appropriate (...) targets for blame when they perform actions that are harmful to the environment. This idea is criticized in this paper. It is argued that instead of blaming individuals for performing actions that are not environmentally friendly we should ascribe forward-looking responsibility to individuals, a notion that focuses more on capacity and resources than causation and blameworthiness. Furthermore, it is important to emphasize that a great share of forward-looking responsibility should also be ascribed to institutional agents, primarily governments and corporations. The urge to ascribe forward-looking responsibility to institutional agents is motivated by the efficiency aim of responsibility distributions. Simply put, if responsibility is ascribed to governments and corporations there is a better chance of creating a society in which the opportunities to act in an environmentally friendly way increase. (shrink)

An approach to explaining the nature and source of logic and its laws with a rich historical tradition takes the laws of logic to be laws of thought. This view seems intuitively compelling, after all, logic seems to be intimately related with how we think. But how exactly should we understand it? And what arguments can we give in favour? I will propose one line of argument for the claim that the laws of logic are laws of thought. I will (...) motivate the claim that there is a certain phenomenon, namely, that there are logical principles which are immune to rational doubt. I will then give an argument to the best explanation; I will argue that the best explanation of this phenomenon is to take the laws of logic to be constitutive-normative laws of thought. The proposal, and some responses to potential objections, will have a notably Kantian flavour. (shrink)

Newtonian forces are pushes and pulls, possessing magnitude and direction, that are exerted (in the first instance) by objects, and which cause (in particular) motions. I defend Newtonian forces against the four best reasons for denying or doubting their existence. A running theme in my defense of forces will be the suggestion that Newtonian Mechanics is a special science, and as such has certain prima facie ontological rights and privileges, that may be maintained against various challenges.

New scientific advances have created previously unheard of possibilities for enhancing combatants' performance. Future war fighters may be smarter, stronger, and braver than ever before. If these technologies are safe, is there any reason to reject their use? In this article, I argue that the use of enhancements is constrained by the importance of maintaining the moral responsibility of military personnel. This is crucial for two reasons: the military's ethical commitments require military personnel to be morally responsible agents, and moral (...) responsibility is necessary for integrity and the moral emotions of guilt and remorse, both of which are important for moral growth and psychological well-being. Enhancements that undermined combatants' moral responsibility would therefore undermine the military's moral standing and would harm combatants' well-being. A genuine commitment to maintaining the military's ethical standards and the well-being of combatants therefore requires a careful analysis of performance-enhancing technologies before they are implemented. (shrink)

Multi-user online environments involve millions of participants world-wide. In these online communities participants can use their online personas – avatars – to chat, fight, make friends, have sex, kill monsters and even get married. Unfortunately participants can also use their avatars to stalk, kill, sexually assault, steal from and torture each other. Despite attempts to minimise the likelihood of interpersonal virtual harm, programmers cannot remove all possibility of online deviant behaviour. Participants are often greatly distressed when their avatars are harmed (...) by other participants’ malicious actions, yet there is a tendency in the literature on this topic to dismiss such distress as evidence of too great an involvement in and identification with the online character. In this paper I argue that this dismissal of virtual harm is based on a set of false assumptions about the nature of avatar attachment and its relation to genuine moral harm. I argue that we cannot dismiss avatar attachment as morally insignificant without being forced to also dismiss other, more acceptable, forms of attachment such as attachment to possessions, people and cultural objects and communities. Arguments against according moral significance to virtual harm fail because they do not reflect participants’ and programmers’ experiences and expectations of virtual communities and they have the unintended consequence of failing to grant significance to attachments that we take for granted, morally speaking. Avatar attachment is expressive of identity and self-conception and should therefore be accorded the moral significance we give to real-life attachments that play a similar role. (shrink)

Seat belt mandates seem like a paradigmatic case of justified paternalism. Even those who generally object to paternalism often concede that seat belt laws are justified. Against this near-consensus in favor of mandates, I argue that seat belt laws are unjust and public officials should not enforce them. The most plausible exceptions to a principle of anti-paternalism do not justify seat belt mandates. Some argue that seat belt mandates are not paternalistic because unbelted riders are not fully autonomous. Others claim (...) that the decision to ride unbelted harms other people. Yet these attempts to defend seat belt mandates on non-paternalistic grounds cannot overcome the case against seat belt mandates. I therefore conclude that even seat belt mandates are unjust. With this comprehensive case against seat belt mandates, I demonstrate the more general difficulties in justifying any form of coercive paternalism. (shrink)

Perception of temporal patterns is fundamental to normal hearing, speech, motor control, and music. Certain types of pattern understanding are unique to humans, such as musical rhythm. Although human responses to musical rhythm are universal, there is much we do not understand about how rhythm is processed in the brain. Here, I consider findings from research into basic timing mechanisms and models through to the neuroscience of rhythm and meter. A network of neural areas, including motor regions, is regularly implicated (...) in basic timing as well as processing of musical rhythm. However, fractionating the specific roles of individual areas in this network has remained a challenge. Distinctions in activity patterns appear between "automatic" and "cognitively controlled" timing processes, but the perception of musical rhythm requires features of both automatic and controlled processes. In addition, many experimental manipulations rely on participants directing their attention toward or away from certain stimulus features, and measuring corresponding differences in neural activity. Many temporal features, however, are implicitly processed whether attended to or not, making it difficult to create controlled baseline conditions for experimental comparisons. The variety of stimuli, paradigms, and definitions can further complicate comparisons across domains or methodologies. Despite these challenges, the high level of interest and multitude of methodological approaches from different cognitive domains (including music, language, and motor learning) have yielded new insights and hold promise for future progress. (shrink)

The thesis that in order to genuinely think about a particular object one must be (in some sense) acquainted with that object has been thoroughly explored since it was put forward by Bertrand Russell. Recently, the thesis has come in for mounting criticism. The aim of this paper is to point out that neither the exploration nor the criticism have been sensitive to the fact that the thesis can be interpreted in two different ways, yielding two different principles of acquaintance. (...) One principle uses the notion of content in distinguishing genuine thinking-about things from a merely derivative kind of thinking-about things. The other principle is quiet about content, focusing instead on a distinction between satisfactional and non-satisfactional means of bringing things into thought. Most work has focused on the first, content-based principle of acquaintance. But criticisms of this principle do not apply straightforwardly to the non-content-based principle. I shall argue that the latter principle merits independent assessment as part of the broader effort to account for genuine thinking about particular objects. In the final section of the paper, I will sketch a roadmap for this assessment. (shrink)

The idea that one can blamelessly violate a norm is central to ethics and epistemology. The paper examines the prospects for an account of blameless norm violation applicable both to norms governing action and norms governing belief. In doing so, I remain neutral on just what are the norms governing action and belief. I examine three leading suggestions for understanding blameless violation of a norm which is not overridden by another norm: doxastic accounts; epistemic accounts; and appeal to expected value. (...) We see that all of these accounts face problems when understood as accounts of blameless norm violation applicable to both belief and action. This leaves a variety of options including seeking an alternative account of blameless norm violation common to belief and action; concluding that we cannot determine the correct account of blameless norm violation independently of what are the norms of belief; and abandoning the project of finding a common account of blameless norm violation common to ethics and epistemology. (shrink)

Hume argued that experience could not justify commonly held beliefs in singular causal effcacy, according to which individual or singular causes produce their effects or make their effects happen. Hume's discussion has been influential, as motivating the view that Causal reductionism (denying that causal efficacy is an irreducible feature of natural reality) requires Causal generalism (according to which causal relations are metaphysically constituted by patterns of events). Here I argue that causal reductionists---indeed, Hume himself---have previously unappreciated resources for making sense (...) of Causal singularism, associated with a relation that has been curiously underexploited in the causation debates: resemblance. The core idea I explore here is that causation may be metaphysically and epistemologically indicated by the coming-to-be of a resemblance. Comings-to-be of resemblances are epistemically available in the singular instance, even by Hume's strict lights, and, I argue, can justify (albeit fallibly) belief in the holding of singular causal relations; hence Hume's general argument for generalism fails. More to the contemporary metaphysical point, comings-to-be of resemblances provide valuable resources for existing singularist accounts: while neither changes (Ducasse) nor transfers of physical quantities (Fair, Dowe, Salmon) provide a suffciently fine-grained basis for the individuation of causes, either changes or transfers, in combination with comings-to-be of resemblances, can do so. (shrink)

ABSTRACT:We discuss workers’ dignity in hierarchical organizations. First, we explain why a conflict exists between high-ranking individuals’ authority and low-ranking individuals’ dignity. Then, we ask whether there is any justification that reconciles hierarchical authority with the dignity of workers. We advance a communitarian justification for hierarchical authority, drawing upon Confucianism, which provides that workers can justifiably accept hierarchical authority when it enables a certain type of social functioning critical for the good life of workers and other involved parties. The Confucian (...) communitarian perspective shows that promoting workers’ good life or well-being is an important condition for protecting their dignity. (shrink)

While separate pieces of research found parents offer toddlers cues to express that they are joking and pretending, and that toddlers and preschoolers understand intentions to joke and pretend, it is not yet clear whether parents and toddlers consider joking and pretending to be distinct concepts. This is important as distinguishing these two forms of non-literal acts could open a gateway to understanding the complexities of the non-literal world, as well as the complexities of intentions in general. Two studies found (...) parents offer explicit cues to help 16- to 24-month-olds distinguish pretending and joking. Across an action play study and a verbal play study parents showed more disbelief and less belief through their actions and language when joking versus pretending. Similarly, toddlers showed less belief through their actions, and older toddlers showed less belief through their language. Toddlers' disbelief could be accounted for by their response to parents' language and actions. Thus, these studies reveal a mechanism by which toddlers learn to distinguish joking and pretending. Parents offer explicit cues to distinguish these intentions, and toddlers use these cues to guide their own behaviors, which in turn allows toddlers to distinguish these intentional contexts. (shrink)

In this paper, it is argued that selection and drift might be distinct. This contradicts recent arguments by Brandon (forthcoming) and Matthen and Ariew (2002) that such a distinction “violates sound probabilistic thinking” (Matthen and Ariew 2002, 62). While their arguments might be valid under certain assumptions, they overlook a possible way to make sense of the distinction. Whether this distinction makes sense, I argue, depends on the source of probabilities in natural selection. In particular, if the probabilities used in (...) defining fitness values are at least partly a result of abstracting from or ignoring certain features of the environment, then selection and drift might in fact be causally distinct. (shrink)

Volume 20, Issue 4, May 2020, Page 108-110.

The use of anecdotes is not a viable research strategy to study animal culture. Social learning processes can often be documented with careful quantitative analyses of observational data. Unfortunately, suggestions that killer whales engage in teaching are entirely based on subjective interpretations of qualitative observations. Thus, of teaching in killer whales cannot be used to argue for the occurrence of culture in marine mammals.

This article explores notions about Nietzsche’s career as a philologist and his fascination with the Greeks. It considers his interest in Homer and the Greek philosophers—in particular, Heraclitus and Pyrrho. For Nietzsche, ancient Greeks such as Heraclitus and Homer were interesting not because of their doctrines, but because of the example they themselves provided of certain psychological types. Like the ancient skeptics following Pyrrho, Nietzsche was generally more interested in the psychological consequences of philosophical doctrines than in their content, and (...) like those skeptics he often rejected any ambitions to limn the true nature of reality. (shrink)

When writing on forgiveness, most authors focus on when it is appropriate to forgive and the role that the offender’s attitudes play in determining the appropriateness of forgiveness. In this paper I will take a different approach. Instead of examining when forgiveness may or may not be appropriate, I discuss the moral attitude displayed by being unforgiving. I argue that we have reason to strive for forgiveness based on the kind of moral outlook we deplore in those who wrong us, (...) and that we strive to remove from our own moral worldview. Believing someone to be unforgivable can result in the adoption of aspects of the wrongdoer’s moral outlook and so forgiveness is worth attempting for reasons unconnected to the wrongdoer’s attitudes: reasons that arise from the kinds of moral agents we strive to be. (shrink)

Questions of persistence and change are central to metaphysics. There is almost always a role for sortal or essential properties to play in theories of persistence. However, one might reasonably be suspicious of many of the claims about sortal properties and essential properties on which so many accounts of persistence conditions rest. The aim of this paper is to think through what persistence looks like if we don't help ourselves to these assumptions. In so doing, we shall uncover a deep (...) and difficult problem when it comes to identity facts and their relation to qualitative facts. Towards the end of the paper, I sketch a potential line of response that builds upon our seeming awareness of a genuinely persisting self. (shrink)

Many if not all evidential languages have a mirative evidential: an indirect evidential that can, in some contexts, mark mirativity (the expression of speaker surprise) instead of indirect evidence. We address several questions posed by this systematic polysemy: What is the affinity between indirect evidence and speaker surprise? What conditions the two interpretations? And how do mirative evidentials relate to other mirative markers? We propose a unified analysis of mirative evidentials where indirect evidentiality and mirativity involve a common epistemic component. (...) A mirative interpretation requires a close temporal proximity between the speech event and the event of the speaker's learning the at-issue content. (shrink)

_Offers a striking new reading of Agamben’s political thought and its implications for political action in the present._.

This paper discusses the notion of necessity in the light of results from contemporary mathematical practice. Two descriptions of necessity are considered. According to the first, necessarily true statements are true because they describe ‘unchangeable properties of unchangeable objects’. The result that I present is argued to provide a counterexample to this description, as it concerns a case where objects are moved from one category to another in order to change the properties of these objects. The second description concerns necessary (...) ‘structural properties’. Although I grant that mathematical statements could be considered as necessarily true in this sense, I question whether this justifies the claim that mathematics as a whole is necessary. (shrink)

Lies come in different sizes. There are little white lies, slight stretches, exaggerations, fibs, and whoppers. Such terms can reflect different aspects of lies, but one of these is how far a lie is from what the liar really thinks. This paper proposes that this dimension of lie-size reflects a scalar aspect of sincerity. Drawing inspiration from the study of truthlikeness, the paper elucidates this aspect of sincerity, which I call “truthful-likeness”. Truthful-likeness reflects how sincere a reply to a question (...) is, based on how close the speaker takes the reply to be to their best available one. A related measure, expected subjective truth factor, reflects how sincere a constative act that is not a reply to a question is, based on how close to being true the speaker thinks it is. (shrink)

Currently our assessment of whether someone is a good parent depends on the environmental inputs (or lack of such inputs) they give their children. But new genetic intervention technologies, to which we may soon have access, mean that how good a parent is will depend also on the genetic inputs they give their children. Each new piece of available technology threatens to open up another way that we can neglect our children. Our obligations to our children and our susceptibilities to (...) corresponding legal and moral sanctions may be about to explosively increase. In this paper I argue that we should treat conventional neglect and 'genetic neglect'– failing to use genetic intervention technologies to prevent serious diseases and disabilities – morally consistently. I conclude that in a range of cases parents will have a moral obligation to use genetic treatments to prevent serious disabilities in their children. My particular focus is on prenatal interventions and their impact of the bodily integrity of expectant mothers. I conclude that although bodily integrity constrains moral obligations, it is outweighed in a range of cases. (shrink)

Recent feminist theorizing has pointed to a `resurgent patriarchy' within neo-liberal postfeminist times, which re-orders and restabilizes the heterosexual matrix through a politics of `postfeminist masquerade' demanded of girls and women (McRobbie). This paper seeks to complicate this thesis, exploring the regulation and rupture of Butler's `heterosexual matrix' as a complex performative politics through which girls' conflictual relationships with themselves, and other girls and boys are staged and through which dominant versions of tweenage and teenage femininity are reinscribed but also (...) reworked, in race and class specific ways. Drawing on Deleuze and Guattari's powerful conceptual repertoire for disrupting Oedipal logics in Anti-Oedipus, we offer a `molecular mapping', illustrating cracks and ruptures in what is a porous heterosexual matrix, exploring a rhythm of `deterritorializations' and `reterritorializations' of the normative in our respective ethnographic and narrative interviews with girls. We also trace more sustained ruptures of heteronormative femininity drawing upon Deleuze and Guattari's notion of `lines of flight' and Braidotti's concept of `alternative figuration'. We argue ruptures and alternative figurations are not constitutive of total `molar' resistance to norms, but are significant spaces of doing girl differently and crucial to map if we are to perceive the malleability and multiplicity of contemporary girl subjectivities, which exceed heteronormative femininity and phallogocentric desire. (shrink)

In September 2009, the First Circuit Court of Appeals decided Blue Cross & Blue Shield v. AstraZeneca Pharmaceuticals LP, part of the class action suit known as In re Pharmaceutical Industry Average Wholesale Price Litigation. The First Circuit upheld a Massachusetts District Court finding that AstraZeneca violated Massachusetts’ consumer protection laws by manipulating the “average wholesale price” of its physician-administered injectable cancer drug Zoladex, leading to overpayment by the government, third-party payers, and consumers. This case, which highlights the persistent tension (...) between pharmaceutical pricing flexibility and consumer protection, has important implications for similar pending class actions.Between 1991 and 2003, Medicare, as well as many private insurance companies, pegged reimbursement for certain pharmaceutical products to a national “average wholesale price” for each drug. Although the amended 1991 Medicare Part B regulations3 that introduced the term “average wholesale price” failed to define it explicitly, there is some indication in the legislative history that AWP was intended to refer to the prices that physicians and pharmacists actually pay to the drug manufacturers. (shrink)

ResumenEl artículo se propuso indagar el término compuesto de naturaleza sagrada partiendo del supuesto que la naciente conciencia ecológica posee voces que abogan por ella. Sin embargo, la composición del término trae la paradoja de unir dos órdenes de realidad que occidente ha escindido. De esta manera, se expone una reflexión epistemológica y ética. La reflexión epistemológica se enriqueció con la pesquisa sobre lo sagrado. En ella se descubre a la naturaleza como una hierofanía donde convergen lo divino, lo humano (...) y lo cósmico, por lo que se trasciende la dicotomía entre naturaleza y lo sagrado. En la reflexión ética se revisaron tres ideas interconectadas: la percepción de la sacralidad de la naturaleza se basa en una visión unitaria y orgánica de la realidad, esta percepción conlleva una actitud reverencial hacia la naturaleza que va acompañada de la responsabilidad cósmica del ser humano de mantener los equilibrios del universo. Se concluye que una nueva cosmología y antropología está emergiendo, pero están en el orden del mito, sus logos están todavía en la penumbra, de ahí que la indagación a la naturaleza sagrada puede abrir una experiencia y un discurso que permita hacer del mundo un hogar de cuidado reverencial. Palabra clave: naturaleza sagrada; epistemología; ética; cosmología organicista; reverencia. (shrink)

The American Journal of Bioethics, Volume 12, Issue 10, Page W1-W2, October 2012.

We consider Walker's thorough review in the context of thinking about future research on the relation between sleep and memory. We first address methodological issues including type of memory and sleep-stage dependency. We suggest a broader investigation of potential signaling molecules that may be critical to sleep-related consolidation. A brief review of the importance of the stress hormone cortisol illustrates this point.

This chapter explores the prospects for justifying the somewhat widespread, somewhat firmly held sense that there is some moral advantage to untruthfully implicating over lying. I call this the "Difference Intuition." I define lying in terms of asserting, but remain open about what precise definition best captures our ordinary notion. I define implicating as one way of meaning something without asserting it. I narrow down the kind of untruthful implicating that should be compared with lying for purposes of evaluating whether (...) there is a moral difference between them. Just as lying requires a robust form of assertion, so the kind of untruthful implicating to be compared with lying requires a robust form of implicating. Next, I set out various ways of sharpening the Difference Intuition and survey a range of approaches to justifying one class of sharpenings. I finish by sketching an approach to justifying an alternative sharpening of the Difference Intuition, which is inspired by John Stuart Mill's discussion of lying. (shrink)

BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

ABSTRACTCurrent discourse about higher education focuses on issues like government funding, student debt, and admissions diversity; however, increasing attention is being paid to issues of speech and politics in the university. Alongside a series of events at several institutions, calls for ‘safe space’ on campus have grown familiar. Yet the appropriateness of such spaces on campus is debated. In this article the notion of safety implied in calls for ‘safe space’ is clarified, and three reasons are suggested for supporting such (...) safety pedagogically. A public reason is proposed, which relies on a normative interpretation of publicness as conjoint action. This substantive version of ‘public’ could be considered when assessing the institution’s publicness, rather than typical elements of the university’s nominal publicness. By embracing and ensuring safe space, universities could become sites of public full participation, thus fostering a re-recognition of higher education as a public good. (shrink)

This article furnishes a systematisation of the Mediaval aesthetic vocabulary. This task is developed by means of the adoption of a dynamic of intersection among the various Aristotelic species qualitatis, which are taken as the basic structural elements of the requested system. Two versions of beauty are established, which will expand into two kinds of aesthetics, one leaded by pulchritudo, with intellectualistic implications and the other leaded by formositas, which will turn into an autonomus aesthetics; both of them have let (...) a strong legacy to contemporaneus aesthetics. (shrink)

Prior research has documented how important it is to patients to be able to trust their physicians. In this essay, we introduce physician perspectives on the importance of earning patients’ trust. We conducted twelve semistructured interviews in late 2022, eleven with physicians and one with a patient‐experience expert. Physicians described earning patients’ trust as crucial for working effectively with patients, with several saying that it was as important as having medical knowledge. Physicians also expressed that feeling a patient trusting them (...) is professionally rewarding and fulfilling. To build trust with patients, physicians reported, they make the medical interaction all about the patient, express their belief in their patients, share their personal experiences, and use other strategies identified in previous literature: communicating effectively, being compassionate, and demonstrating competence. Physicians also reported experiencing challenges in building trust with patients, most often because of patients’ lack of trust in other levels of the health care system and because of having inadequate time to spend with patients. Additionally, Black and Brown physicians described how patients’ bias often blocks trust. (shrink)