Research Article
Negotiating trust during times of uncertainty: haemophilia and AIDS
,Abstract
Trust forms the core of healing relationships. Mistrust can co-exist and complement trust by enabling patients’ to challenge medical decisions without fear of repercussion, thereby negotiating a more patient-centric approach. While trust can safeguard the therapeutic relationship during periods of medical uncertainty, a reappraisal of trust at such times can lead to its loss, adversely affecting this relationship. This occurred during the 1980s when haemophilia patients contracted AIDS from their treatment, a situation of iatrogenic harm at a time of evolving uncertainty. Published literature on how this impacted on doctor’s response is absent. Using legal and narrative material from the UK and elsewhere, this paper will address profoundly distressing dilemmas in the stance of haemophilia physicians towards their patients during the 1980s and how this impacted on trust. The paper argues that trust and mistrust are fluid during times of uncertainty. This trust is subject to social forces that are ethically challenging and beyond individual control. Its recovery requires fresh societal debate. This understanding is of fundamental importance in the training of medical students and doctors to become better physicians.
Keywords
haemophiliaAIDSInfected Blood Inquiryiatrogenicethicaluncertaintytrustmistrusttherapeutic relationshipCopyright statement © The author(s) 2023. This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License
Cite this article Sekhar with Jadhav (2023), ‘Negotiating trust during times of uncertainty: haemophilia and AIDS’, Journal of the British Academy, 11(6): 069 https://doi.org/10.5871/jba/011s6.069

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This article examines the detrimental effects of Kenya’s wide-ranging policies, strategies and tactics of waging the war on terror at the Kenya coast. The ‘war’ is waged through police-related killings and enforced disappearances and is becoming counterproductive as it is contributing to a loss of citizenship rights for an increasing segment of the population. These grievances are rarely portrayed in the public sphere but continue to manifest in the suffering of families, livelihood losses, increased stigmatisation and, most importantly, through violation of the citizenship rights of widows and their orphaned children. Using interview data from the Kenya coast, the article attempts to shift beyond perceiving women and young people as perpetrators of violence to seeing them as silent victims of the war on terror. The article analyses these dynamics from community and civil society perspectives. It contributes to the emerging literature on women and violent extremism by examining the silent suffering of widows and their children, who often are neither seen nor heard.
In the Harvard lectures that became Art as Experience (1934) Dewey developed a democratic account of art that not only expanded the range of creative experience (watching a huge digger, the architectonics of a mutually satisfactory conversation, are included in the reach of art) but developed an account of art that was vitally reciprocal, participatory and social. Maker and perceiver are equally interactive creators as they mutually develop new modes of feeling and thinking. For Dewey this relationship necessarily re-makes the experience of community and, just as important, creates a civic space for interrogation and critique. (This article is published in the thematic collection ‘The arts and humanities: rethinking value for today—views from Fellows of the British Academy’, edited by Isobel Armstrong.)

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