Trust and sense making in dominant-subordinate relationships: the case of trust violation and patient safety

This paper examines the role of sense-making in maintaining trust within dominant-subordinate relationships, following trust violation, addressing the question “Why do people carry on trusting despite evidence to the contrary?” Whilst recognizing the role of hierarchy, accounts of sense-making have tended to emphasise agency and shared sense-sense-making or consensual adequacy. They have consequently tended to neglect how following presumptive trust individuals may be socialized into trusting behaviour that complies with norms dictated by more powerful actors, even where a trust violation offers evidence that becoming vulnerable will result in harm. Using their trust relationship with hospital employees, patients’ sense making of trust violations in relation to their safety is examined. The contribution we make is therefore two-fold. Firstly we explore the implications for trust of how service users make sense of events where there may be opportunity for discrepant sense-making. Secondly by focusing on service users’ narratives we examine processes by which, in the face of contradictory information, trust is maintained