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12 - Reasons for the Decline of Trust

from Part V - The Decline of Trust

Published online by Cambridge University Press:  19 August 2019

Markus Wolfensberger
Affiliation:
Universität Basel, Switzerland
Anthony Wrigley
Affiliation:
Keele University
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Summary

In this chapter, the authors present five changes in people’s attitude and behaviour, which not only can explain the decline of trust, but which must almost inevitably lead to a decline of trust. The first four changes may be summarised under the heading ‘loss of physicians’ authority’: (1) the discrediting of ‘professionalism’, which has led to a decline of professional authority; (2) the insistence on (and difficulty of) assessing physicians’ trustworthiness and the loss of merit-based authority; (3) a questioning of physicians’ medical authority caused by the disavowal of the basic tenets of scientific medicine (often referred to as the ‘crisis of modern medicine’); (4) increasing doubts regarding the physician’s agency and directive authority caused by the perceived commodification of medicine and a reconceptualisation of physicians as dependent employees. The fifth change refers to changes of risk perception and increasing risk-averseness. Contrary to what many believe, it is not risks which have increased, but uncertainty. Yet, people perceive this increase of uncertainty as an increase of risk – a risk which an increasing number of people are no longer willing to accept.

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Trust in Medicine
Its Nature, Justification, Significance, and Decline
, pp. 173 - 204
Publisher: Cambridge University Press
Print publication year: 2019

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