Elements of trust: Risk and perspective-taking

Trust is essential to personal well-being and economic success, but it cannot occur without accepting the possibility of betrayal. In the experimental trust game, game-theoretic rationality prescribes that trust decisions should depend on the potential risk (egocentric costs and benefits) and the probability of reciprocity (derived from the trustee's temptation to defect). The current work tests the relative weights of these elements. Experiment 1 shows that trust increases when costs decrease and benefits increase. The latter finding is critical because increasing the trustor's benefit also means increasing the trustee's temptation to defect. Hence, this finding suggests that egocentrism prevails over perspective-taking. Experiment 2 shows that the trustee's temptation to defect (negatively) affects trust, but only when the trustor's cost and benefit are favorable. Results are interpreted as reflecting a boundedly rational decision process.     

Social Capital and Organizational Commitment

Organizational scientists have been investigating the role of human relationships vis-à-vis firm productivity for some years. Recently, Social Capital has been theorized to play a central part in the reduction of organizational transaction costs. We briefly position Social Capital among several theories claiming a role for interpersonal capital, review its theoretical nuances, and test this theoretical structure using a sample of 469 sales professionals from a leading medical services firm. Our findings indicate that trust, communication, and employee focus have significant direct and moderate indirect affects on organizational commitment.     

Forms of trust in education and development

In this article an analysis of trust is given and two basic forms of trust are distinguished, viz., trust in powers and trust in inclinations. These forms of trust allow us to gain a better understanding in the pivotal role trust plays in the relationship between caretakers, parents and children. It is argued that it makes no sense to speak about basic mistrust of infants, and that having unlimited trust in the inclinations of adults is only a virtue in children. By having trust in both the powers and inclinations of children, parents stimulate the development of their self-confidence and moral identity.     

Caregivers’ Level of Trust in Their Children's Health Care Providers

Trust in healthcare providers is associated with clinical outcomes among adult patients. Children with disabilities have complex health needs that place stress on caregivers. Consequently, they are increasingly likely to rely on their children's health care providers to ensure children's health care needs are met. However, no studies have explored factors affecting caregivers’ trust in their children's providers. We assessed caregivers’ trust in their children's providers and identified predictive factors of trust. The results indicate that children's disability condition, functional status, age, the providers’ specialty, and the type of health care plan are significant predicators of caregiver's trust. Specifically, caregivers of children with emotional/behavioral disabilities and children with poor physical or emotional/behavioral functioning reported less trust in their children's providers compared to caregivers of children without physical disabilities or no disability and those having higher levels of physical or emotional/behavioral functioning. In addition, caregivers of younger children had more trust compared to caregivers of older children. Caregivers of children enrolled in a managed care plan for physical health care reported less trust compared to caregivers of children in other organizational arrangements. Finally, caregivers reported more trust in physical health providers compared to mental health providers.     

The incremental validity of organizational commitment,organizational trust,and organizational identification

Organizational commitment (OC), organizational trust (OT), and organizational identification (OI) are three types of psychological attachment to an organization. Each of these three variables captures an organization-targeted attitude toward an employment relationship, but it is unclear whether they have incremental validity over each other. To address this question, this study examined the incremental validity of each variable in predicting job involvement, job satisfaction, turnover intentions, and non-self-report measures of task performance and citizenship behavior. It also examined whether perceived organizational support and psychological contract breach, two other organization-targeted attitudinal variables, were related to OC, OT, and OI when the latter were considered jointly. Meta-analytical evidence suggests that OC, OT, and OI have incremental validity over and above one another in their relationships with some, but not all, of the above correlates. This highlights the need for future research to distinguish these three types of psychological attachment to an organization.     

Patient Perspectives on the Learning Health System: The Importance of Trust and Shared Decision Making

We conducted focus groups to assess patient attitudes toward research on medical practices in the context of usual care. We found that patients focus on the implications of this research for their relationship with and trust in their physicians. Patients view research on medical practices as separate from usual care, demanding dissemination of information and in most cases, individual consent. Patients expect information about this research to come through their physician, whom they rely on to identify and filter associated risks. In general, patients support this research, but worry that participation in research involving randomization may undermine individualized care that acknowledges their unique medical histories. These findings suggest the need for public education on variation in practice among physicians and the need for a collaborative approach to the governance of research on medical practices that addresses core values of trust, transparency, and partnership.     

ICD-11 guidelines for psychotic,mood, anxiety and stress-related disorders in Mexico: Clinical utility and reliability

Background/Objective: The World Health Organization's diagnostic guidelines for ICD-11 mental and behavioural disorders must be tested in clinical settings around the world to ensure that they are clinically useful and genuinely global. The objective is evaluate the inter-rater reliability and clinical utility of ICD-11 guidelines for psychotic, mood, anxiety- and stress-related disorders in Mexican patients. Method: Adult volunteers exhibiting the selected symptoms were referred from the pre-consultation unit of a public psychiatric hospital to an interview by a pair of clinicians, who subsequently assigned independent diagnoses and evaluated the clinical utility of the diagnostic guidelines as applied to each particular case, on the basis of a scale developed for this purpose. Results: 23 clinicians evaluated 153 patients. Kappa scores were strong for psychotic disorders (.83), moderate for stress-related (.77) and mood disorders (.60) and week for anxiety and fear-related disorders (.43). A high proportion of clinicians considered all diagnostic guidelines to be quite to extremely useful as applied to their patients. Conclusions: ICD-11 guidelines for psychotic, stress-related and mood disorders allow adequate inter-rater consistency among Mexican clinicians, who also considered them as clinical useful tools.     

Gauthier and the Capacity for Morality

In Morals by Agreement, David Gauthier tries to provide a justification of morality from morally neutral premises within the constraints of an instrumental conception of reason. But his reliance on this narrow conception of reason creates problems, for it suggests that moral motivation is self-interested. However, Gauthier holds that to act morally is to act for the sake of morality and others, not oneself. An individual who so acts has what he calls an affective capacity for morality. He attempts to reconcile the tension between the self-interested account of moral behaviour and the affective capacity for morality by showing that the latter could develop from the former without violating the constraints of instrumental rationality. I argue, first, that his account is incomplete and assumes what it has to demonstrate; and, second, that this cannot be remedied with any plausibility. Finally, I argue that Gauthier covertly relies on a substantive claim about human good that is inconsistent with the instrumental conception of reason. This revised version was published online in July 2006 with corrections to the Cover Date.     

Managing financial conflicts of interest in clinical research

Upholding public trust in clinical research necessitates that human subjects be protected from avoidable harm and that the design, interpretation and reporting of research results be shielded from avoidable bias. On both counts, managing financial conflicts of interest is critically important, especially in the modern era when the opportunities for investigators to benefit personally from the commercialization of their intellectual property are overtly encouraged and rapidly expanding. Efforts are underway in the United States to provide more useful guidance to universities and medical schools for purposes of strengthening the oversight and management of financial conflicts of interest in clinical research. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

Trustworthiness in explanation: The obligation to explain well

‘Scientific integrity’ certainly requires that data and references be beyond reproach. However, issues within the theory of scientific explanation suggest that there may be more to it than just this. While it is true that some contemporary, pragmatic analyses of explanation suffer from the ‘problem of relevance’ (an inability to ensure that explanations which are paradigmatic technically are relevant to the question being posed), it does not seem to be true that the addition of formal, metaphysical constraints is necessary to solve this problem. I argue that, when viewed as requests for help with an epistemic problem, explanation-seeking questions reveal the existence of a set of moral criteria centered in trust which, when satisfied, prevent trivial or irrelevant explanations from being offered, thereby broadening the concept of ‘scientific integrity’.