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Trust but verify
  1. Sissela Bok
  1. Correspondence to Dr Sissela Bok, Harvard Center for Population and Development Studies, Harvard School of Public Health, Cambridge MA, USA; sbok{at}hsph.harvard.edu

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I agree with Dr Eyal that the ‘trust-promotion argument for informed consent’ fails to account for common sense intuitions about informed consent.1 Appealing to ‘social trust, especially trust in caretakers and medical institutions’ cannot, by itself, justify informed consent requirements. And stipulating, in the trust-promoting argument's first clause, that such trust is necessary is an invitation to abuse, in healthcare systems as much as in political systems. Those who are asked to give their informed consent to medical procedures have every reason for healthy scepticism, given the well-documented inadequacies of existing healthcare systems. ‘Trust but verify’—the Russian folk saying that President Ronald Reagan invoked in negotiating with Soviet leaders—has relevance in a great many circumstances, not least for individuals before agreeing to undergo medical procedures or to participate in clinical studies.

While it is in no way necessary for these individuals to trust health professionals, much less medical institutions more generally, what is necessary is for the health professionals …

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