Trust, Reflexivity and Dependence
A 'Social Systems Theory' Analysis in/of Medicine
in European Journal of Social QualitySearch for other papers by Paul Ward in
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Given the centrality of 'trust' in both the Theory of Social Quality and as a central motif of life in late modernity, this paper focuses attention on public (mist)trust in social systems and the potential ramifications of engagement with medical services, in addition to feelings of social exclusion and disembeddedness. Using data from a qualitative study of lay perceptions of local primary health care services, the paper reveals the complex and often contradictory ways in which trust is won, developed and lost. In addition, mistrust in local general practitioners (GPs) was found to be a factor of mistrust in a variety of social systems, organisations and institutions of government, rather than solely related to mistrust of either the GPs or the medical system. Nevertheless, there was not a widespread abandonment of the use of GPs or Western medicine, which may partly be explained by the perceived dependence of these people these people on the medical system. Overall, generalised mistrust existed at both inter-personal and systems-based levels and was levied at a variety of social systems and institutions of governance – mistrust was a pervading dimension of life in this community.