I explore Baier, Held, Okin, Code, Noddings, and Eisler on trust and distrust. This reveals a need for reflection on the analysis, ethics, and dynamics of trust and distrust-especially the distinction between trusting and taking for granted, the feasibility of choosing greater trust, and the possibility of moving from situations of warranted distrust to trust. It is impossible to overcome the need for trust through surveillance, recourse to contracts, or legal institutions.

The legitimacy of the refusal of South Australian nurses to care for second trimester abortion patients on grounds of conscience is examined as a test case for a theory of permissible limits on the autonomy of health care professionals. In cases of health care professional (HCP) conscientious refusal, it is argued that a balance be struck between the HCPs' claims to autonomous action and the consequences to them of having their autonomous action restricted, and the entitlement of patients to care (...) and the consequences for them of being refused such care. Conscientious action that results in the disruption or termination of health care services, however, is always impermissible on two grounds. Firstly, because it is at this point that the action '... invades a patient's autonomy, puts a patient at serious risk ... [and] treats a patient unjustly' (1) Secondly, because the consequences of such refusals turn them into political acts--acts of civil disobedience. It is arguable that in order for acts of civil disobedience to be legitimate, certain obligations are required of the dissenter by the community. It is concluded that the actions of the South Australian nurses, which have over the last few years both terminated and disrupted second trimester services, are morally impermissible. (shrink)

In On Certainty, the emphasis is on the solitary individual as subject of knowledge. The importance of our dependence on others, however, is brought out in Wittgenstein's remarks about trust. In this paper, the role and nature of trust are discussed, the grammar of trust being contrasted with that of reliance. It is shown that to speak of trust is to speak of a fundamental attitude of one person towards others, an attitude which, unlike reliance, is not to be explained, (...) or assessed, by an appeal to reasons. It is, rather, because we have such a fundamental readiness to accept what we are taught by others that we can come to develop an understanding of reasons. The idea that believing something without evidence is always a weakness is shown to be a philosophical prejudice. Trust is always for something we can rightfully demand from others: misplaced trust, accordingly, is not a shortcoming on the part of the trustful person, but of the person in whom the trust was placed. The destruction of trust is a tragedy of life; in Culture and Value, Wittgenstein suggests a connection between distrust and madness. (shrink)

Introduction These essays have been written over a period of about ten years and have already been published separately in various places. ...

In recent years, virtue theories have enjoyed a renaissance of interest among general and medical ethicists. This book offers a virtue-based ethic for medicine, the health professions, and health care. Beginning with a historical account of the concept of virtue, the authors construct a theory of the place of the virtues in medical practice. Their theory is grounded in the nature and ends of medicine as a special kind of human activity. The concepts of virtue, the virtues, and the virtuous (...) physician are examined along with the place of the virtues of trust, compassion, prudence, justice, courage, temperance, and effacement of self-interest in medicine. The authors discuss the relationship between and among principles, rules, virtues, and the philosophy of medicine. They also address the difference virtue-based ethics makes in confronting such practical problems as care of the poor, research with human subjects, and the conduct of the healing relationship. This book woith the author's previous volumes, A Philosophical Basis of Medical Practice and For the Patient's Good, are part of their continuing project of developing a coherent moral philosophy of medicine. (shrink)