Browsing by Subject "Trust"
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Item Being trustworthy in today's medical world(2014-09-09) Potter, Nancy NyquistIs there still a place for trust in today's health care practices? Is it even possible to make time for trusting relations? The short answer is, yes -- depending on how we think about issues of trust. The framework for arguing that trust is still an inviolable quality in health care is that of trust and trustworthiness as virtues. Despite time pressures and the dominance of technologies, being trustworthy is part of professional ethical practices. We will talk about what trust is, when and why there are reasons to care about being trustworthy, and consider what should be done when trust goes wrong. Cases for discussion will be presented.Item Building trust in a time of turmoil(2023-02-03) Lee, Thomas H.Item Maintaining trustworthiness in NIH public-private partnerships (The Daniel W. Foster, M.D., Visiting Lectureship in Medical Ethics)(2018-10-09) Lo, BernardPublic-private partnerships (PPPs) can benefit the public, but recent National Institutes of Health (NIH) cases illustrate how PPPs may raise important concerns about conflicts of interest (COIs). A proposed PPP to accelerate new treatments for opioid addiction had to be substantially modified after it was disclosed that several private partners were opioid manufacturers being sued by state attorneys general for allegedly promoting the opioid crisis. The project will now be carried out using only public funds. Another PPP, a large clinical trial to determine the long-term effects of moderate alcohol consumption, was harshly criticized after it was revealed that five large alcohol manufacturers are providing most of the $100 million cost of the study. NIH has ordered two investigations of this trial. The high reputation of NIH should be protected in any PPP. NIH should develop comprehensive policies to assure transparency in PPPs and appropriately limit undue influence and bias.Item Serious ethical violations in medicine: dealing effectively with outlier peers(2020-02-11) DuBois, James M.[Note: The video is not available from this event.] This presentation will engage the problem of serious ethical violations in medicine (SEMs). Examples of SEMs include criminal prescribing of controlled substances, performing unnecessary surgeries for profit, and sexually abusing patients. SEMs harm patients, waste scarce resources, and profoundly damage trust in medicine, particularly when institutions are perceived as enabling abuse. Drawing from his NIH-funded study of more than 300 cases of SEMs, DuBois will share findings on the motives and environmental factors that enable violations to occur. While SEMs are relatively rare, the current oversight system is ineffective at preventing repeat instances of SEMs by offenders. DuBois will share consensus recommendations offered by a diverse panel of physician leaders and educators, lawyers, ethicists, and patient advocates, and explore the ethical and practical challenges involved in reforming oversight and disciplinary systems.Item Trust as a Predictor of Eating Disorder Severity and Therapeutic Alliance in an Adolescent Clinical Sample(2015-07-21) Krol, Heather Paige Lefkof; Stewart, Sunita M.; Latimer, Kelsey M.; McAdams, Carrie J.; Kelley, Urszula; Westers, NicholasTrust is recognized as an important construct across many disciplines. Despite this recognition, trust has proven difficult to define and measure, due to its abstract nature and variety of properties. Economic exchanges have become the standard measure of behavioral trust. A recent version, the "Trust Game," provides a unique opportunity to examine behavioral trust in an interactive, interpersonal situation. The Trust Game has been useful in demonstrating patterns of trust behavior in several psychiatric populations. Currently, the Trust Game has yet to be examined with adolescents suffering from eating disorders (EDs). These individuals are at high risk for deleterious outcomes, including an increased mortality risk, and thus early intervention and effective treatment are critical. Limited research exists on the role of trust in patients with EDs, and even less is known about the relationship of trust to factors important to treatment. The present study sought to address this gap in the literature by examining the relationship between behavioral trust and factors relevant to ED treatment, including attachment, self-reported trust, depression, ED severity, and the therapeutic alliance. This study also examined if behavioral trust predicts factors associated with treatment outcomes, including ED severity and therapeutic alliance, above and beyond depression. The sample consisted of 40 adolescents (ages 12-18) who were admitted to either inpatient or partial-hospitalization levels of care for an ED. Participants completed questionnaires and played the Trust Game with a computer simulated "healthy stranger." This pilot investigation found that behavioral trust was partially associated with attachment to parents, and only one aspect of the game related to self-reported trust. The results showed that higher overall game earnings explained unique variance in ED severity, after controlling for depression. Finally, this study found limited relationship between behavioral trust and the therapeutic alliance, although important aspects of the alliance were explored. The findings from this study increase our understanding of behavioral trust, as measured by the Trust Game, in adolescents with EDs and the relevance with factors important to the treatment of this population. Implications for clinicians, limitations of the methodology, and suggested areas for future research are discussed.Item Trust in the medical profession: rebuilding trust one patient at a time(2021-07-02) Newman, Jason