The New Trends in Medicine and Trust

  • Anna LIADOVA Lomonosov Moscow State University, Moscow, Russia
Keywords: trust, medicine, doctor-patient relationship, informed consent

Abstract

Over the last years, the Russian National Health Care System has undergone a number of great changes. These reforms are motivated by the whole transformation of medicine as a social institute. As it showed by the numerous studies, under the process of the globalization and new technologies the clinical practice has been changed. The high technologies in medicine have incorporated new trends in practice and lead to use exactly hard evidence for diagnosis and treatment. But spending on new health technology increases healthcare costs.  Now the main trend is the standardization of practice, that is relied on evidence-based medicine as it reduces costs. The great damage to the physician-patient relationship in these movements is that the patient is considered secondary, without attention to his individual characteristics and needs. It ignores the individuality and leads to the uniformity. It affects the doctor-patient relationship. As it well known, trust is a keystone of effective doctor-patient relationship. It may be considered as a belief of an individual that trustee will care of his (a patient’s) needs and interests. But, under the modern trends in medicine, there has been changed the doctor-patient relationship. The paternalistic model has been evolved into the new form based on a personal informed consent. And now the question is that what role trust plays now? Based on the data of the sociological research, it was revealed, that over last years, the public trust to doctors and the national health care system has been unsatisfied and unstable. So, it may be pointed out, that the informed consent could not be only legal compulsion and defence for doctors in case of adverse treatment outcome. It is also an ethical obligation as no consent could not be an insurance for doctors to avoid legal liability. So, mutual trust as a keystone of doctor-patient relationship has been still actual for the current concept of the social interaction in medical practice.

References

[1] Birkhauer J., Gaab J., Kossowsky J., Hasler S., Krummenacher P., Werner C., et al. Trust in the health care professional and health outcome: A meta-analysis. PLoS ONE. [Internet]. 2017. 12 (2). Available from: URL: https:// doi:10.1371/journal.pone.0170988
[2] Boyd K. The impossibility of informed consent? Journal Med Ethics. 2015. Vol. 41 (12). December. pp. 44–47
[3] Carmena del M. G., & Joffeb S. Informed Consent for Medical Treatment and Research: A Review. The Oncologist. 2005, September. 10 (8). pp. 636-641
[4] Eyal N. Using informed consent to save trust. Journal Med Ethics. 2012, December. Vol. 8. pp. 1–8
[5] Freik N. V. Concept of trust in works of P.Sztompka. Sociologicheskie issledovanija. 2006, (11). pp. 10-8. (in Russian)
[6] Fukujama F. Trust: The Social Virtues and the Creation of Prosperity. M.: OOO «Izdatel'stvo AST»: ZAO NPP «Ermak»; 2004. 730 p. (in Russian)
[7] Giddens A. The consequences of modernity. Cambridge: Polity Press; 1992. 186p.
[8] Gopichandran V. Trust in healthcare: an evolving concept. Indian Journal of Medical Ethics. 2013. Vol.10 (2). April-July. pp. 79-82
[9] Gopichandran V., & Chetlapalli S. Factors influencing trust in doctors: a community segmentation strategy for quality improvement in healthcare. BMJ Open. [Internet]. 2013. 3(12). Available at https: doi: 10.1136/bmjopen-2013-004115
[10] Hall D. E., Div M., Prochazka A. V., & Fink A. S. Informed consent for clinical treatment. CMAJ. 2012 Mar 20; 184(5). pp. 533–540. doi: 10.1503/cmaj.112120
[11] Kochkina N.N., Krasil'nikova M.D., & Shishkin S.V. Dostupnost' i kachestvo medicinskoj pomoshhi v ocenkah naselenija. M.: Izdatel'skij dom Vysshej shkoly jekonomiki. 2015. p. 56
[12] Krot K., Ridawska I. The role of trust in doctor-patient relationship: qualitative evaluation of online feedback from polish patients. Economics & Sociology. 2016. 9 (3). pp. 76-88
[13] Lee W.-H., Kim I.S., Kong B.-H., Kim S. Probing the Issue of Informed Consent in Health Care in Korea—Concept Analysis and Guideline Development. Asian Nursing Research. 2008. Vol. 2(2). June. pp. 102-112
[14] Luhman N. Trust and power. N.Y: J.Wiley; 1979. p. 208
[15] Mechanic D. Changing Medical Organization and the Erosion of Trust. The Milbank Quarterly. 1996. Vol.74 (2) pp. 171-189
[16] Mechanic D. The Functions and Limitations of Trust in the Provision of Medical Care. Journal of Health Politics, Policy and Law. 1998. Vol. 23 (4). pp. 661-686.
[17] O’Neill O. Autonomy and trust in bioethics. Cambridge: Cambridge University Press. 2002
[18] Parsons T. Modern Social Systems. M.: Aspekt-Press; 1998. p. 270 (in Russian).
[19] Public Opinion Pull Fund. The Report: Trust to doctors and their mistakes. March, 21, 2013. [Internet]. Available at: http://fom.ru/Zdorove-i-sport/10866
[20] Public Opinion Pull Fund. The Self-medication. 13.09. 2008 г. [Internet]. Available at: https://bd.fom.ru/report/cat/home_fam/healthca/d083723
[21] Russian Public Opinion Research Center. Dynamics in relation to the population of Russia to health in 2014-2016. [Internet]. Available at: https://wciom.ru/index.php?id=238&uid=116018
[22] Seligmen A. The problem of trust. M.: Ideja-press; 2002. 200 p. (in Russian)
[23] Sizer L., & Arnold Ph. The changing paradigm of the doctor-patient relationship: Montgomery v Lanarkshire Health Board and developments in the ‘duty to warn’. The New Zealand Medical Journal. 2016, January. Vol. 129 (1429). pp. 71-76
[24] Yousuf R M, Fauzi A. R. M, How S. H, Rasool A. G, & Rehana K. Awareness, knowledge and attitude towards informed consent among doctors in two different cultures in Asia: a cross-sectional comparative study in Malaysia and Kashmir, India. Singapore Med Journal.. 2007. Vol. 48 (6). pp. 559-565
Published
2018-08-13
How to Cite
LIADOVA, A. (2018). The New Trends in Medicine and Trust. LUMEN Proceedings, 3, 266-273. https://doi.org/10.18662/lumproc.nashs2017.22