What Do We Mean by Public Trust? Conceptualising Public Trust in Healthcare Systems

Challenges

Public trust in healthcare systems is widely recognised as important for effective public health action, influencing vaccination uptake, data sharing, and engagement with health services. Despite its prominence in research and policy, “public trust” is often used in broad or ambiguous ways, and is frequently treated as interchangeable with related concepts such as confidence, reliance, or institutional approval. This lack of conceptual clarity makes it difficult to interpret empirical findings and to understand what it would mean, in practice, to strengthen or restore public trust.

Project Aims

This DPhil project examines how public trust in healthcare systems is currently understood and measured in empirical research and compares these approaches with established theories of trust. It explores what is meant by “public trust,” whether it can coherently be understood as an aggregate of individuals' trust, and how far existing measures reflect key features of trust identified in philosophy. By doing so, the project aims to clarify how trust differs from related concepts and why these distinctions matter for healthcare research and policy.

Methods

The project uses empirical bioethics methods, combining a systematic review of the empirical literature with philosophical conceptual analysis. The review maps how public trust is defined and operationalised across healthcare research, including analysis of commonly used survey instruments. This is integrated with conceptual analysis drawing on philosophy to assess how well these measures capture trust and support the claims made on their basis. The project is supervised by Dr Mark Sheehan, Dr Mackenzie Graham, and Dr Richard Milne.