CHAPTER 1: Forms of Trust/Distrust and Dialogicality in Focus-Group Discussions About Medical Confidentiality

Just read newspapers, listen to the news, choose a health insurance, surf on a new website, purchase a new antivirus for your computer: the word “trust” is everywhere. Infusing every fibre of our social activities, it is taken for granted, untold, at least until it is betrayed. It may therefore be defined as an “atmospheric” notion. This “atmospheric” quality of trust (or confidence, a distinction that French language does not make¹) that we all experience in our everyday life, did not escape social scientists. More specifically, Georg Simmel, in an article on secrecy and secret societies (Simmel, 1906), stressed that confidence (“Vertrauen”) in another person is a basic form of human knowledge that evolves with the development of complex organisational forms, namely institutions. He described confidence in another person as “one of the most important synthetic forces within society” (p. 450) and showed that confidence stems from our inability to know everything and, thus, from our interdependence with others. According to Simmel, confidence is “a mediate condition between knowing and not knowing another person. The possession of full knowledge does away with the need of trusting [vertrauen], while complete absence of knowledge makes trust evidently impossible.” (p. 450). In Simmel’s view, confidence is a moral value that commits an individual to another individual. In our own terms, we may say that trust (or confidence) is a sort of moral tacit contract between two or more individuals (cf. also Linell & Marková, 2013) because, as Simmel put it, if somebody trusts us, we commit ourselves to honour his or her confidence. Hence, uncertainty is fully part of trust, a reason why, by the way, Simmel made a difference between confidence and faith (“die Glaube,” which means also “belief”). According to him, the faith that somebody may have in another person is beyond knowing and not-knowing, and belongs to religious faith. Faith is a state of complete acceptance of the other that “is not brought into existence by experiences or by hypotheses” (p. 450, note 1). However, according to Simmel, faith, in its pure state, is probably not possible among human beings because their confidence in another person always needs to be confirmed by experience.