This paper develops and defends a new account of therapeutic trust, its nature and its constitutive norms. Central to the view advanced is a distinction between two kinds of therapeutic trust – default therapeutic trust and overriding therapeutic trust – each which derives from a distinct kind of trusting competence. The new view is shown to have advantages over extant accounts of therapeutic trust, and its relation to standard (non-therapeutic) trust, as defended by Hieronymi, Frost-Arnold, and Jones.

This essay investigates an underappreciated way in which trust and testimonial injustice are closely connected. Credibility deficit and credibility excess cases both (in their own distinctive ways) contribute to a speaker’s being harmed in her capacity a knower. But moreover, as we will show—by using the tools of a performance-theoretic framework—both credibility deficit and credibility excess cases also feature incompetent trusting on the part of the hearer. That is, credibility deficit and excess cases are shown to manifest qualities of thinkers (...) that are inconducive to trust’s being reliably fulfilled. What this implies is an interesting result about testimonial injustice: to the extent that we want to mitigate against testimonial injustice—one promising way to do so will be to target incompetent trusting of the sort that underlies it. We conclude by outlining and defending what we take to be a promising substantive version of such a mitigation strategy, one which is centred around the cultivation of higher-order trusting competences. (shrink)

A widespread assumption in debates about trust and trustworthiness is that the evaluative norms of principal interest on the trustor’s side of a cooperative exchange regulate trusting attitudes and performances whereas those on the trustee’s side regulate dispositions to respond to trust. The aim here will be to highlight some unnoticed problems with this asymmetrical picture – and in particular, how it elides certain key evaluative norms on both the trustor’s and trustee’s side the satisfaction of which are critical to (...) successful cooperative exchanges – and to show that a symmetrical, ‘achievement-first’ approach to theorising about trust and trustworthiness (and their relation to each other) has important advantages by comparison. The view I develop is guided by a structural analogy with practical reasoning. Just as practical reasoning is working as it should only when there is realisation (knowledge and action) of states (belief and intention) with reverse directions of fits (mind-to-world and world-to-mind), likewise, cooperation between trustor and trustee is functioning as it should only when there is an analogous kind of realisation on both sides of the cooperative exchange – viz., when the trustor ‘matches’ her achievement in trusting (an achievement in fitting reliance to reciprocity) with the trustee’s achievement in responding to trust (an achievement in fitting reciprocity to reliance). An upshot of viewing cooperation between trustor and trustee as exhibiting achievement-theoretic structure is that we will be better positioned to subsume trustworthiness (and its cognates on the trustee’s side), like trust, under a wider suite of evaluative norms that regulate attempts, dispositions, and achievements symmetrically on both sides of a cooperative exchange, with ‘matching achievements’ as the gold standard. (shrink)

It is argued that trust is a performative kind and that the evaluative normativity of trust is a special case of the evaluative normativity of performances generally. The view is shown to have advantages over competitor views, e.g., according to which good trusting is principally a matter of good believing (e.g., Hieronymi, 2008; McMyler, 2011), or good affect (e.g., Baier, 1986; Jones, 1996), or good conation (e.g., Holton, 1994). Moreover, the view can be easily extended to explain good (and bad) (...) distrust, where the latter is understood as aimed (narrow-scoped) forbearance from trusting. The overarching framework—which assimilates the evaluative norms of trusting (and distrusting) to performance-theoretic norms—supplies us with an entirely new lens to view traditional philosophical problems about what is involved in trusting and distrusting well and badly, and thus, places our capacity to make progress on problems in this area on a new footing. (shrink)

Without trust there is no credible human health research (HHR). This article accepts this truism and addresses a crucial question that arises: how can trust continually be promoted in an ever-changing and uncertain HHR environment? The article analyses long-standing mechanisms that are designed to elicit trust—such as consent, anonymization, and transparency—and argues that these are best understood as trust represented by proxies of trustworthiness, i.e., regulatory attempts to convey the trustworthiness of the HHR system and/or its actors. Often, such proxies (...) are assumed to operate as markers that trust exists or, at least, has not been lost. But, since trust can neither be “built” nor “secured,” this is a precarious assumption. Worryingly, there is no existing theoretical account of how to understand and evaluate these proxies of trustworthiness as part of a trusted HHR ecosystem. To remedy this, the paper argues for a radical reimagining of trust and trustworthiness as performative acts that ought to be understood in relation to each other and by reference to the common values at stake. It is shown that proxies of trustworthiness are the operational tools used to perform trustworthiness. It advocates for a values-based approach to understanding the relationship between trust and trustworthiness. This establishes a strong basis for an evaluative framework for proxies of trustworthiness, i.e., to determine how to perform trustworthiness well. Five common proxies in HHR are scrutinized from a values perspective. The contribution is to provide a far-reaching normative and practical framework by which existing and future proxies of trustworthiness can be identified, assessed, maintained, or replaced in rapidly changing HHR regulatory ecosystems where trust itself is crucial to the success of the entire HHR enterprise. (shrink)