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Trust and questioning in the acute care setting - a project to assess the role of sharing written information with patients

Dr Zoë Fritz has a Wellcome Trust Ethics and Society Fellowship to explore how appropriate questioning and well-placed trust can be fostered in the acute care setting.

The acute care setting is a unique environment where trust and questioning are particularly important, and where the established shared decision-making model may not be suitable. Although research has been done on patient-doctor trust, it has been done with the premise that patient ‘trust’ is beneficial. In fact poorly placed trust is dangerous and too much trust may discourage questioning. One way of potentially facilitating well-placed trust and appropriate questioning might be to shift away from the current system of keeping medical records in the clinicians’ domain, and share them with patients. However there are also risks associated with sharing medical records. Using empirical ethics methodology, and supervised by Dr Anne-Marie Slowther at Warwick Medical School and by Prof Tim Lewens in the Department of History and Philosophy of Science at the University of Cambridge, Dr Fritz will:

  • Develop a conceptual framework for well-placed trust that will inform policy and practice in the acute medical setting
  • Explore the role of written communication (in particular shared medical records) and facilitated questioning as a component of well-placed trust
  • Develop a practical policy for patient-doctor structured communication for use in an acute medical setting

Dr Fritz has questioned ethical assumptions of current practice with her previous work, investigating the problems with Do Not Attempt CardioPulmonary Resuscitation orders, and developing and evaluating the Universal Form of Treatment Options as an alternative. She has recently been awarded a Wellcome Trust Parliamentary Office of Science and Technology (POST) Fellowship to work at the POST on secondment from her research.