By Dave Langlois, PhD, Clinical Ethicist, The Centre for Clinical Ethics / Providence Healthcare

Trust is among the most precious and ethically complex commodities in health care. Recent research indicates that higher levels of patient trust in their health care providers are correlated with better objective and subjective health outcomes. And, anecdotally, we’re all familiar with how dramatically the presence or absence of trust can influence a patient’s experience. Most ethically complex cases involve the issue of trust.

Trust can shape how a patient hears and interprets difficult news from her physician, whether siblings come to an agreement about the plan of care for one of their parents, and how information is shared in health care teams. Without trust, even simple decisions and transitions can become extremely challenging. And re-establishing trust that’s been lost can be much harder than building it in the first place.

There’s no science of developing and maintaining trusting relationships. But I find that the environments most conducive to trust are those, like Providence, where there’s a strong focus on communication and special attention paid to discussing and understanding each other’s values.

Knowing that someone really hears you and understands how you see the world goes a long way toward making trust feel possible and safe.