Two Models of Trust in Health Care (in Polish)

Aleksandra Głos

About author

Aleksandra Głos
PhD Candidate
Institute of Philosophy
Jagiellonian University in Kraków
ul. Grodzka 52
31-044 Kraków



Trust is a fundament of decent and just health care. In a subtle relation between patient and physician trust not only fuels the process of therapy but also plays a therapeutic role itself. Trust is a precondition of successful cooperation – it lowers its costs, increases efficiency and brings satisfaction to the partners. Only altruistic (as opposed to calculative) trust acts as such. Philosophical arguments as well as experiments analysing birth of trust in health care praxis prove the validity of the altruistic model. Distinction between these two models casts light on the contemporary health care crisis. Many of todays’ reforms improve only cognitive side of trust by increasing predictability and efficiency of the health care system, while neglecting its crucial – ethical side. Article analyses also ambivalent influence of new technologies on these processes.

Full Text:

PDF (In Polish)


  1. A.D. Anderson, Therapeutic trust, „Journal of Chronical Disease” (35) 198, s. 817–820.
  2. L.A. Anderson, R.F. Dedrick, Development of the Trust in Physician Scale: a measure to assess interpersonal trust in patient-physician relationships, „Psychological Reports” (67) 1990, s. 1091–1100.
  3. R.E. Ashcroft, B. McKinstry, J. Car, et al., Interventions for improving patients’ trust in doctors and groups of doctors, „Cochrane Database of Systematic Reviews” (3) 2006.
  4. R. Axelrode, The evolution of cooperation, Basic Books, New York 1984.
  5. A. Baier, Trust and antitrust, „Ethics” 96 (2) 1986, s. 231–260.
  6. L. Bernstein, Private Commercial Law in the Cotton Industry: Creating Cooperation through Rules, Norms, and Institutions, „Michigan Law Review” 99 (7) 2011, s. 1724–1790.
  7. R.J. Blendon, J.M. Benson, M.A., J.O. Hero, Public Trust in Physicians — U.S. Medicine in International Perspective, „The New England Journal of Medi-cine” (371) 2014, s. 570-1572, DOI: 10.1056/NEJMp1407373.
  8. I. Bohnet, B.S. Frey, S. Huck, More Order with Less law: On Contract Enforcement, Trust and Crowding, „American Political Science Review” (95) 2001, s. 131–144.
  9. J. Brownlie, A. Howson, ‘Leaps of faith’ and MMR: An Empirical Study of Trust, „Sociology” SAGE Publications 39 (2), s. 221–239.
  10. Bundesärztekammer, Zunehmende Privatisierung von Krankenhäusern in Deutschland Folgen für die ärztliche Tätigkeit Voraussetzungen, Wirkungen, Konsequenzen und Potenziale aus ärztlicher Sicht, Berlin 2007.
  11. M. Calnan, R. Rowe, Trust relations in health care – the new agenda, „European Journal of Public Health” 2012, s. 4–6.
  12. M. Calnan, D. Montaner, R. Horne, How acceptable are innovative health-care technologies? A survey of public beliefs and attitudes in England and Wales, „Social Science and Medicine” (60) 2004, s. 1937–1948.
  13. J. Coleman, Foundations of social theory, Cambridge, Harvard University Press 1990.
  14. J. Elster, Ulysses and the Sirens: Studies in Rationality and Irrationality, revised edition, Cambridge University Press, Cambridge 1984.
  15. B.S. Frey, Not Just for the Money An Economic Theory of Personal Motivation, Edward Elgar Publishing, 1997.
  16. F. Fukuyama, Trust: The Social Virtues and the Creation of Prosperity, Free Press, New York 1995.
  17. D. Gambetta, Can we trust trust?, [w:] Trust: Making and Breaking Cooperative Relations, D. Gambetta (red.), Basil Blackwell, Oxford 1998, s. 213–237.
  18. A. Giddens, Konsekwencje nowoczesności, Wydawnictwo Uniwersytetu Jagiellońskiego, Kraków 1990.
  19. L. Gilson, J. Goudge, How trust can be investigated? Drawing lessons from past experience, „Social Science & Medicine” (61) 2005, s. 1439–1451.
  20. D. Green, B. Irvine, Healthcare Systems: Germany, Civitas, 2013.
  21. P. Greenspan, A Case of Mixed Feelings: Ambivalence and the Logic of Emotion, [w:] Explaining Emotions, A.O. Rorty (red.), University of California Press, 1980, s. 223–250.
  22. M.A. Hall, E. Dugan, B.Y Zheng, A.K. Mishra, Trust in physicians and medical institutions: What is it, can it be measured, and does it matter?, „Milbank Quarterly” (79) 2001, s. 613–639.
  23. M.A. Hall, F. Camacho, E. Dugan, R. Balkrishnan, Trust in the medical profession: conceptual and measurement issues, „Health Services Research” 37 (5) 2002, s. 1419–1439.
  24. M.A. Hall, B. Zheng, E. Dugan, et al., Measuring patient’s trust in their primary care providers, „Medical Care Research Review” 59 (3) 2002, s. 293–318.
  25. R. Hardin, Trust and Trustworthiness, Russell Sage, New York 2002.
  26. R. Hardin, The street-level epistemology of trust, „Politics and Society” 21 (4) 1993, s. 505–529, [w:] P. Sztompka, Zaufanie. Fundament społeczeństwa, Znak, Kraków, 2007.
  27. M.A. Hillen, Cancer patients’ trust in their Oncologist, Academic Medical Center, University of Amsterdam 2013.
  28. M.A Hillen, C.C.E Koning, J.W. Wilmink, et al., Assessing cancer patients' trust in their oncologist: development and validation of the Trust in Oncologist Scale (TiOS), „Support Care Cancer” 20 (8) 2012, s. 1787–1795.
  29. M.A. Hillen, A.T. Onderwater, M.C.B van Zwieten, et al., Disentangling cancer patients' trust in their oncologist: a qualitative study, „Psycho-oncology” 21 (4) 2012, s. 392–399.
  30. R. Inglehart, Trust, Well-being and Democracy, [w:] Democracy and Trust, M.E. Warren (red.), Cambridge University Press, Cambridge 1999.
  31. K. Jones, Trust as an affective attitude, „Ethics” (107) 1996, s. 4–25.
  32. D. Kahneman, Maps of Bounded Rationality: A Perspective on Intuitive Judgment and Choice, „American Psychologist” 56 (9) 2003.
  33. D. Kahneman, A. Tversky, Prospect Theory: An Analysis of Decisions Under Risk, „Econometrica” 47 (2) 1979, s. 263–291.
  34. A.C. Kao, D.C. Green, N.A. Davis, et al., Patients' trust in their physicians - Effects of choice, continuity, and payment method, „Journal of General Internal Medicine” (13) 1998, s. 681–686.
  35. A.C. Kao, D.C. Green, A.M. Zaslavsky, et al., The relationship between method of physician payment and patient trust, „JAMA” 280 (19) 1998, s. 1708–1714.
  36. J. Mansbridge, Altruistic Trust, [w:] Democracy and Trust, M.E. Warren (red.), Cambridge University Press, Cambridge 1999, s. 290–309.
  37. C. Martin, A. MacGregor, L. Jones, An investigation of the Views of Parents and Professionals in Relation to MMR Vaccination, Edinburgh: Scottisch Health Feedback, [w:] J. Brownlie, A. Howson, ‘Leaps of faith’ and MMR: An Empirical Study of Trust, „Sociology” SAGE Publications 39 (2) 1999, s. 221–239.
  38. M. Marzano, Qu’est ce que la confiance?, RIHME „Revue Interdisciplinaire sur le Management et l’Humanisme“ (1) 2012, s. 83–96.
  39. D. Mechanic, Changing Medical Organization and the Erosion of Trust, „The Milbank Quarterly” 74 (2) 1996), s. 171–189.
  40. D. Mechanic, S. Meyer, Concepts of trust among patients with serious illness, „Social Science and Medicine” (51) 2000, s. 657–668.
  41. G. Möllering, Trust, Reason, Routine, Reflexivity, Elsvier, Oxford 2006.
  42. E. Montague, Trust in technology-mediated collaborative health encounters: Constructing trust in active and passive user interactions with technologies, „Ergonomics” 55 (7) 2012, s. 752–761.
  43. E. Müller, J.M. Zill, J. Dirmaier, et al., Assessment of Trust in Physician: A Systematic Review of Measures, PLoS One „Public Library of Science“ 9 (9) 2014, DOI: 10.1371/journal.pone.0106844.
  44. O. O’Neill, Autonomy and Trust in Bioethics, Cambridge University Press, Cambridge, 2002.
  45. S.D. Pearson, L.H. Raeke, Patients’ Trust in Physicians: Many Theories, Few Measures, and Little Data, „The Journal of General Internal Medicine” 15 (7) 2000, s. 509–513.
  46. R. Rosenfeld, S. Messner, E. Baumer, Social Capital and Homicide, „Social Forces” 80 (1) 2001, s. 283–309.
  47. D.G. Safran, M. Kosinski, A.R. Tarlov, The Primary Care Assessment Survey: tests of data quality and measurement performance, „Medical Care” (36) 1998, s. 728–739.
  48. N. Seetharamu, U. Iqbal, J.S. Weiner, Determinants of trust in the patient-oncologist relationship, „Palliative and Supportive Care” (5) 2007, s. 405-409.
  49. C. Smith, Understanding Trust and Confidence: Two paradigms and Their Significance for Health and Social Care, „Journal of Applied Philosophy” 22 (3) 2005, s. 299–316.
  50. M. Solbjor, You Have to Trust in Those Pictures. A Perspective on Women’s Experiences of Mammography Screening, [w:] J. Brownlie, A. Greene, A. Howson, Researching Trust and Health, Routledge, New York 2008, s. 54–71.
  51. G. Simmel, The Sociology of Georg Simmel, Free Press, New York 1950, [w:] G. Mollering, Trust, Reason, Routine, Reflexivity, Elsvier, Oxford 2006.
  52. P. Sztompka, Zaufanie. Fundament społeczeństwa, Znak, Kraków 2007.
  53. S. Thomson T. Foubister, E. Mossialos, Financing health care in the European Union, The European Observatory on Health Systems and Policies, 2009.
  54. P. Zak, S. Knack, Trust and Growth, „Economic Journal” (111) 2001.
  55. W. Załuski, Człowiek jako homo oeconomicus, [w:] System prawny a porządek prawny, O. Bogucki, S. Czepita (red.), Wydawnictwo Naukowe Uniwersytetu Szczecińskiego, Szczecin 2008, s. 297–315.
  56. B. Zheng, M.A. Hall, E. Dugan, et al., Development of a scale to measure patients’ trust in health insurers, „Health Services Research” 37 (1) 2002, s. 187–202.


Article links:

Default URL:
Polish abstract URL:
English abstract URL:


All works are licensed under a Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) License.