Journal of the ...Volume 11 Supplementary i... Negotiating tru...
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Research Article

Negotiating trust during times of uncertainty: haemophilia and AIDS

orcid-imageMallika Sekharemail-imageMallika Sekhar

Dr Mallika Sekhar trained in India, London, and USA. She is a Consultant Haematologist at Royal Free London NHS Trust and Honorary Associate Professor of Haematology at University College London. Her clinical and research interests include chronic disorders of the marrow, and medical error. She heads the transfusion service and has established a UK registry for a rare clotting condition. https://thebitterpillpodcasts.libsyn.com

email-image Mallika.sekhar@nhs.net

,
orcid-imageSushrut JadhavSushrut Jadhav

Professor Sushrut Jadhav is a street Psychiatrist and clinician anthropologist in London, U.K. He works as Professor of Cultural Psychiatry at University College London and as Consultant Psychiatrist at Camden Homeless Outreach Services for the Mentally Unwell, Camden & Islington NHS Foundation Trust, London, UK.

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 relationship
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Published on: 19 December 2023
Volume: 11
Issue: Supplementary issue 6
Article ID: 069
Pages:69 - 101
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© The author(s) 2023.
Cite this article
Sekhar with Jadhav (2023), ' Negotiating trust during times of uncertainty: haemophilia and AIDS ', Journal of the British Academy, 11(Supplementary issue 6): 069 https://doi.org/10.5871/jba/011s6.069

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Thematic article

Normal View Dyslexic View

Negotiating trust during times of uncertainty: haemophilia and AIDS

orcid-imageMallika Sekharemail-imageMallika Sekhar

Dr Mallika Sekhar trained in India, London, and USA. She is a Consultant Haematologist at Royal Free London NHS Trust and Honorary Associate Professor of Haematology at University College London. Her clinical and research interests include chronic disorders of the marrow, and medical error. She heads the transfusion service and has established a UK registry for a rare clotting condition. https://thebitterpillpodcasts.libsyn.com

email-image Mallika.sekhar@nhs.net

,
orcid-imageSushrut JadhavSushrut Jadhav

Professor Sushrut Jadhav is a street Psychiatrist and clinician anthropologist in London, U.K. He works as Professor of Cultural Psychiatry at University College London and as Consultant Psychiatrist at Camden Homeless Outreach Services for the Mentally Unwell, Camden & Islington NHS Foundation Trust, London, UK.