Autonomy and Trust in Medicine

In liberal and individualized societies, the patient's self-determination is rightly held in high esteem. However, the freedom of the individual in a highly complex world structured by scientific and technical rationalities only increases insofar as trust in persons and systems is made possible. An abundance of choices and the high risks involved in the practice of medicine leave even competent individuals incapable of taking action unless they are supported by trust-building social systems. Since autonomy is a key concept in modern societies, the same must apply to trust. After all, the vulnerability and insecurity of stakeholders tend to increase rather than decrease as modern medicine's scope for action expands. Hence, this research focuses on approaches to conceptualize autonomy in a more relational or social way. We investigated how interpersonal trust or system trust and self-determination practices in medicine are related, how they are generated or undermined, and how they are justified. Special attention was paid to organizations and institutions, e.g., the hospital, as well as collective actors, e.g., the family or patient groups. Which roles do they play in the interpretation and implementation of trust and autonomy in medicine?

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