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.

A bi-level account of trust is developed and defended, one with relevance in ethics as well as epistemology. The proposed account of trust—on which trusting is modelled within a virtue-theoretic framework as a performance-type with an aim—distinguishes between two distinct levels of trust, apt and convictive, that take us beyond previous assessments of its nature, value, and relationship to risk assessment. While Ernest Sosa (2009; 2015; 2017), in particular, has shown how a performance normativity model may be fruitfully applied to (...) belief, my objective is to apply this kind of model in a novel and principled way to trust. I conclude by outlining some of the key advantages of the performance-theoretic bi-level account of trust defended over more traditional univocal proposals. (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)

A bi-level account of trust is developed and defended, one with relevance in ethics as well as epistemology. The proposed account of trust—on which trusting is modelled within a virtue-theoretic framework as a performance-type with an aim—distinguishes between two distinct levels of trust, apt and convictive, that take us beyond previous assessments of its nature, value, and relationship to risk assessment. While Sosa, in particular, has shown how a performance normativity model may be fruitfully applied to belief, my objective is (...) to apply this kind of model in a novel and principled way to trust. I conclude by outlining some of the key advantages of the performance-theoretic bi-level account of trust defended over more traditional univocal proposals. (shrink)

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)

There are two broad views in the epistemology of testimony, conservatism and liberalism. The two views disagree over a particular necessary condition on testimonial justification: the positive reasons requirement (PRR). Perhaps the most prominent objection levelled at liberalism from the conservative camp stems from gullibility; without PRR, the thought goes, an objectionable form of gullibility looms large for liberals. In this paper I aim to make two main contributions: to introduce a new metric for adjudicating this debate; and to argue (...) that, from the perspective of this new metric, the liberal view is stronger than has been appreciated. Drawing on work from James (The Will to believe and other essays in Popular Philosophy, Harvard University Press, 1896), Goldman (Epistemology and Cognition, Harvard University Press, 1986), and Kelp et al. (Synthese 197:5187–5202, 2020), I firstly countenance the distinction between positive and negative epistemic measures. Positive measures concern, roughly, the acquisition of truths, whereas negative measures concern the avoidance of falsehoods. Both, it is argued, are relevant to epistemic justification, but this debate has proceeded in such a way as to overemphasise the importance of the latter over the former. Once this distinction is made, new conceptual terrain opens for the liberal. Rather than being resigned to a predominantly defensive role—of mitigating worries about negative measures—the liberal can go on the offensive, and explore the independent epistemic strengths of their position. The upshot is that liberals have a new way to dispel their most prominent objection. (shrink)