Patient Trust Research Articles

What every intensivist should know about: Trust in the ICU

Trust is an essential element in the relationship between patients and intensive care unit (ICU) clinicians. Without a foundation of trust, communication is difficult, conflict is more likely, and even clinical outcomes can be affected. The ICU is a particularly challenging environment for trust to flourish. Illness occurs suddenly, emotions can be charged, the environment is impersonal, and there is rarely a prior relationship between patients and their caregivers. Therefore, intensivists must have some understanding of the factors that impact patient and family trust, as well as the actions they can take to improve it.

Patient-dentist communication and its impact on dental services utilisation as perceived by patients in Libya.

To identify the factors influencing communication between patients and dentists in Libya and their effects on patient satisfaction and trust. We explored the impact of these interactions on the subsequent utilisation of dental health services from the patient's perspective. Qualitative descriptive study in a purposive sample of patients from oral health centres in Janzour city in Libya who were over eighteen years old. Sixteen semi-structured interviews (30-90 minutes) were conducted online. Trust was the prime concern among patients. Other factors also positively impacting communication and patient satisfaction included information interaction, active participation, moral support, explanation about processes and the dentists' comprehension of how a patient feels. The online interviews revealed four key thematic areas that reflected the patient-dentist communication phases: 1) Welcoming and establishing a good interpersonal rapport phase; 2) the Information-sharing phase; 3) Treatment decision-making phase, and 4) Satisfaction self-evaluation phase. These data emphasise the significance of soft skills, particularly effective communication, in the context of dental practice. The findings underscore the importance of personal values and interpersonal skills among dental professionals, as these factors play a pivotal role in shaping the success of dental healthcare provision.

Raising professionalism concerns as a medical student: damned if they do, damned if they don’t?

BackgroundUnderstanding professionalism is an essential component of becoming a doctor in order to ensure the trust of patients and wider society. Integrally linked to the concept of professionalism is the importance of identifying and raising concerns to ensure high quality, safe patient care. It is recognised that medical students are uniquely placed to identify and report concerns given their frequent rotations through multiple clinical placements and their peer relationships and, in so doing, develop and enact their own medical professionalism. Although there is existing literature exploring medical students’ willingness to raise concerns about observed professionalism lapses, this has largely been in the context of clinical interactions. Medical students will however undoubtedly encounter concerning behaviours or attitudes in their fellow students, an area that has not specifically been reported upon. This study therefore set out to explore medical students’ willingness to report professionalism concerns they encounter both within and away from the clinical setting, particularly focusing on peer-related concerns.Methods10 medical students, in later clinical years of a large UK medical school, volunteered to take part in in-depth semi-structured interviews. Interviews were recorded, transcribed and then analysed thematically to generate themes and subthemes to represent central organising concepts.ResultsThree broad themes were generated from the data. Hidden curricular effects including role models, hierarchical structures and the operational systems in place to raise concerns subconsciously influenced students’ decisions to raise concerns. Secondly, students offered a range of justifications to defend not taking action, including considering their own vulnerabilities and values alongside demonstrating empathy for perceived mitigating circumstances. The third theme highlighted the complex interplay of influencing factors that students considered when encountering professionalism issues in their peers including wider peer cohort effects and a desire to maintain individual peer-relationships.ConclusionsMedical students will inevitably encounter situations where the professionalism of others is brought into question. However, despite clear curricular expectations to report such concerns, these findings demonstrate that students undergo a complex decision-making process in determining the threshold for reporting a concern through navigating a range of identified influencing factors. This study highlights the important role medical schools play in helping reduce the inner conflict experienced by medical students when raising concerns and in ensuring they provide supportive processes to empower their students to raise concerns as part their own developing professionalism.

Linking patient-centered communication with cancer information avoidance: The mediating roles of patient trust and literacy

ObjectivesThis study, drawing on the pathway mediation model developed by Street and his colleagues (2009) that links communication to health outcomes, explores how patient-centered communication affects cancer information avoidance. MethodsData was gathered through online access panel surveys, utilizing stratified sampling across Germany, Switzerland, the Netherlands, and Austria. The final sample included 4910 non-cancer and 414 cancer patients, all receiving healthcare from clinicians within the past year. ResultsThe results demonstrated that patient-centered communication is directly associated with reduced cancer information avoidance, especially among cancer patients. Additionally, this association is indirectly mediated through patient trust and healthcare literacy. ConclusionThe findings provide empirical evidence that reveals the underlying mechanism linking clinician-patient communication to patient health information behavior. Practice implicationsThe potential of clinician-patient communication in addressing health information avoidance is highlighted by these findings. Future interventions in healthcare settings should consider adopting patient-centered communication strategies. Additionally, improving patient trust and literacy levels could be effective in reducing cancer information avoidance.

A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease.

Diabetes-related foot disease (DFD) is one of the most prevalent causes of global hospitalisation and morbidity, and it accounts for up to 75% of lower-extremity amputations globally. The 5-year mortality rate following any amputation ranges from 53% to 100%. Early identification of wounds and multidisciplinary management can reduce amputation rates by 39-56%. Rural and remote communities and Indigenous populations are disproportionately affected by DFD. This is reflected in amputation rates, which are much higher for Indigenous than for non-Indigenous Australians and for those in very remote areas than for those in major cities or inner regional areas. The large geographical spread of the population in Australia is a substantial barrier for those providing or accessing health services, particularly multidisciplinary and specialist services, which undoubtedly contributes to poorer DFD outcomes in rural and remote communities. A real-time, video-based telehealth service for DFD management was established at the Royal Adelaide Hospital Vascular Services clinic to improve access to specialist services for rural and remote Aboriginal and Torres Strait Islander communities. An exploratory qualitative study that utilised one-on-one, semi-structured interviews was conducted with 11 participants who identified as Aboriginal and who had participated in the telehealth foot service. Interviews were transcribed, de-identified and analysed using thematic analysis, using an inductive approach. Four interrelated themes emerged. 'Practical benefits of staying home' describes the reduced burden of travel and advantages of having local healthcare providers and support people at consultations. 'Access to specialists and facilities' highlights how some participants felt that there was a lack of appropriate facilities in their area and appreciated the improved access telehealth provided. 'Feeling reassured that a specialist has seen their feet' reflects the positive impact on wellbeing that participants experienced when their feet were seen by specialist health staff. 'Facilitates communication' describes how participants felt included in consultations and how seeing a person on screen assisted conversation. The advantages of real-time, video-based telehealth go beyond reduced travel burden and improved access to specialist care. This model of care may facilitate relationship-building, patient wellbeing, and feelings of trust and safety for Aboriginal and Torres Strait Islander DFD patients.

THE INFLUENCE OF PERCEIVED HOSPITAL SERVICE QUALITY ON PATIENTS' HEALTH-RELATED QUALITY OF LIFE AND REVISIT INTENTION

Improved hospital service quality is anticipated to enhance the Health-Related Quality of Life (HRQL) for patients with heart and internal medicine diseases. This cross-sectional study at Persahabatan General Hospital (RSUP Persahabatan) explores the influence of perceived hospital service quality on HRQL and revisit intentions among 120 cardiology and internal medicine outpatient clinic patients. Findings reveal no direct impact on HRQL and revisit intention, but a significant influence on patient satisfaction and trust. Patient satisfaction acts as a crucial mediator between service quality perception and HRQL and revisit intention, emphasizing the need for enhanced procedural ease and healthcare staff training at RSUP Persahabatan.

Role of Artificial Intelligence in Detecting Neurological Disorders

AI plays a pivotal role in detecting neurological disorders by leveraging advanced technologies to analyze vast amounts of data and aid in diagnosis. Here are several key roles AI plays. Artificial Intelligence (AI) has emerged as a revolutionary tool in the realm of healthcare, particularly in the early detection and accurate diagnosis of neurological disorders. The present paper delves into the multifaceted applications of AI specifically tailored to identify and discern various neurological conditions. AI's prowess in medical imaging analysis has significantly advanced the field by enabling nuanced and precise identification of neurological anomalies. By meticulously analyzing MRI scans, CT scans, and X-rays, AI-driven algorithms excel in detecting subtle patterns indicative of diverse neurological disorders such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, and brain tumors. These technologies not only enhance diagnostic accuracy but also enable early intervention and improved patient outcomes. Moreover, AI leverages extensive datasets encompassing clinical records, genetic information, and biosensor data to predict and assess an individual's susceptibility to neurological disorders. Predictive analytics powered by machine learning models, aid in risk assessment, paving the way for personalized medicine and proactive healthcare strategies. Ethical considerations underscore the implementation of AI in neurological disorder detection, emphasizing the need for transparent algorithms, stringent data privacy protocols, and unbiased AI systems to ensure patient confidentiality and trust in healthcare. The evolving landscape of AI in neuroscience presents an exciting frontier, fostering collaborations between AI experts and neuroscientists. Together, they aim to unravel the intricacies of neurological disorders, pushing the boundaries of innovation and paving the path toward early detection, targeted treatments, and improved quality of life for individuals affected by these conditions. This paper highlights the transformative impact of AI in detecting neurological disorders, 7emphasizing its role in early detection, personalized medicine, ethical considerations, and the potential for collaborative advancements in neuroscience.

Nursing Interpersonal Communication Model for Schizophrenia Patients at Tampan Mental Hospital Pekanbaru

Schizophrenia is a neurological disorder and a serious type of mental illness that affects the patient's perception, thinking, language, emotions, and social behavior. Communicating with individuals suffering from schizophrenia requires special techniques because they tend to experience self-concept issues, immerse themselves in their own world, and exhibit physical well-being but mental unhealthiness. Effective communication with schizophrenia patients necessitates skilled nursing techniques and the ability to communicate effectively. From the perspective of communication science, the relationship between the nurse and the patient falls under interpersonal communication, or from the standpoint of health communication, it is therapeutic communication. The communication between the nurse and the patient creates interpersonal interaction using linguistic symbol systems, such as verbal and nonverbal systems. This study aims to describe and analyze interpersonal communication between nurses and Schizophrenia patients at Rumah Sakit Jiwa in the Riau Province. The research utilizes a case study method. The results show that the interpersonal communication used by nurses with schizophrenia patients at Tampan Mental Hospital in the Riau Province involves empathy, positive attention, and sincere acceptance demonstrated through both verbal and nonverbal forms. This fosters trust and openness in patients towards nurses, ultimately contributing to the improvement of schizophrenia patients' healing process.

Telemedicine Practice: Current Challenges of Consent and Autonomy, Patient Privacy and Data Security Worldwide

Background: Telemedicine, facilitating medical services remotely, introduces ethical concerns. Safeguarding patient data, ensuring informed consent, addressing access disparities, and managing biases in artificial intelligence-driven diagnoses are critical. Navigating these challenges ethically is essential for harnessing telemedicine benefits while upholding patient trust and welfare. Objective: To ascertain the primary obstacles affecting global telemedicine practice, including issues concerning patient confidentiality, privacy, autonomy, informed consent, and data security. Methodology: Conducted a systematic literature review, for which we searched two databases (Pubmed and Google Scholar) between January 2018 to December 2022. Broad terms such as ethical issues, legal issues, health care providers were used as keyword searches. The authors used a narrative approach according to PRISMA guidelines 2020 (Checklist). The authors did a qualitative synthesis of selected studies according to inclusion criteria. The inclusion criteria required articles that reported ethical and legal concerns associated with the use of telemedicine; the full texts articles were electronically available and published in English. Systematic reviews and papers in other languages are not a part of the study. Results: Results showed that most reported ethical and legal concerns were related to privacy and confidentiality, followed by informed consent, patient autonomy and data security. From the 16 papers reviewed, authors identified or discussed the following ethical concerns faced by healthcare professionals during the use of telemedicine: patient privacy was addressed in 75% (n = 12/16) studies, informed consent 56.25% (n = 9/16), patient autonomy 31.25% (n = 5/16), data security 25% (n = 4/16). Conclusions: In the dynamic landscape of telemedicine, healthcare providers and policy makers play pivotal roles in addressing its ethical and legal concerns. Collaborative efforts are essential to establish clear guidelines, secure patient data, ensure informed consent, and create adaptable regulations, fostering a responsible and effective telemedicine ecosystem.

The association of family doctor contract service and patient trust in doctor: evidence from twenty-five village clinics of three counties in rural China

BackgroundChina is implementing the family doctor (FD) system to reform the primary healthcare (PHC). The family doctor contract service (FDCS) policy plays a crucial role in this system implementation, aiming to transform the doctor-patient relationship and enhance PHC quality. This study aims to investigate the impact of FDCS on the doctor-patient relationship in PHCs using field research methodology.MethodThe field research methodology was employed to address the research questions. Quantitative methods were utilized for data collection and analysis. A structure questionnaire was used to collect data based on the research questions. Our investigation encompassed twenty-five village clinics across three counties in China. A total of 574 subjects helped us to finish this investigation in the study. The collected data was analyzed using statistical analysis including ordinary least squares (OLS) model and propensity scores matching model (PSM) to estimate the relationship.ResultThe findings from ordinary least squares (OLS) regression revealed that FDCS had a positive influence on patient trust in doctors within PHCs, with patients who participated the FDCS exhibiting higher levels of trust compared to those who did not participate. Propensity score matching (PSM) analysis further confirmed these results by accounting for selection bias.ConclusionsThe implementation of family doctor contract service has brought about significant transformation in the doctor-patient relationship within rural Chinese PHCs. In essence, it has revolutionized the service model of doctor in PHC, playing a pivotal role in improving primary health quality and enhance the service capability of doctors in PHC. This transformative process has been crucial for carrying out hierarchical diagnosis and treatment policy, which aims to adjust the medical service structure and optimizing the health service system. Therefore, it is imperative for government authorities and health administration departments to ensure continuous support for this essential service through appropriate formulation.

Routine Outcome Monitoring from Psychotherapists' Perspectives: A Framework Analysis Study of Expected Benefits and Difficulties.

Psychotherapists' attitudes and expectations towards routine outcome monitoring can impact the likelihood of its fruitful implementation. While existing studies have predominantly focused on Europe and North America, research in Latin America remains limited. The aim of this study is to explore therapists' expected benefits and difficulties prior to implementing a routine outcome monitoring system in a university psychotherapy service in Ecuador. An exploratory and descriptive cross-sectional qualitative study was carried out with 20 participants aged 21 to 47. Semi-structured interviews were conducted to explore participants' knowledge about routine outcome monitoring, their expectations of the difficulties, benefits, usability and risks of using a monitoring system, as well as their expectations about their role in the process. The data analysis adhered to the framework analysis methodology, leading to the identification of six overarching themes, 36 specific themes and 82 subthemes. The interviews highlighted a spectrum of positive and negative expectations at several levels: institutional/general, therapeutic process, therapists, and clients. Perceived benefits encompassed various aspects, including the availability of supplementary information, continuous adaptation of the therapeutic process, facilitation of organization and treatment planning, opportunities for professional development, and fostering patient trust and empowerment. On the other hand, anticipated difficulties comprised concerns such as discomfort among therapists and clients, increased workload, system usage and technical difficulties, and the risk of excessive quantification. Overall, participants expressed more anticipated benefits than difficulties. We present recommendations that can support and optimize the current local implementation efforts of routine outcome monitoring, both within this service and in other settings. These recommendations consider ways to meet positive expectations and address or mitigate negative ones.

Industry Sponsorship in Dentistry: An Ethics Scoping Review

Evidence to guide dentistry on conflict of interest (COI) and professional-industry relationships is limited. To determine the breadth of literature regarding ethics in dentistry and COI relating to sponsorship. A scoping review following the PRISMA extension was performed. Medline/PubMed and Cochrane Library databases were used to identify peer-reviewed sources, published 2013-2023. Titles, abstracts, and full-text reviews were conducted by two independent reviewers. Disagreements were resolved by consensus. The remaining studies underwent critical appraisal. Key findings were extracted and analyzed. Adjusted for critical appraisal thresholds, we evaluated a total of (n=9) studies associated with dentistry, COI, and sponsorship (industry and non-profit research funding). The majority of evidence demonstrated a significant correlation with disclosure of COI and professional ethical conflict. More than 32% of publications demonstrated no clear disclosure or failed to report COI. Sponsored studies demonstrated significantly greater scrutiny of disclosure practices, whereas industry/dentist-reported payments were prevalent but varied widely (19% to 62%). Regardless of funding or influence, dental professionals are likely to disclose industry conflicts when presented with policies to guide transparency, thus strengthening patient trust and professional code of ethics.

It’s the Small Things: An Intersectional Approach to African American Women on Medicaid Receiving Prenatal Care

Background: When examining prenatal care utilization rates, African American women were more likely to receive inadequate prenatal care. Yet, research about African American women’s prenatal care experiences fails to account for how their experiences may vary by socioeconomic status and insurance type. Therefore, the purpose of this study was to provide African American women on Medicaid with the opportunity to speak to what they found to be meaningful during their interactions with their prenatal care provider using an intersectionality framework.Methods: Individual interviews were conducted with pregnant African American women (n = 20) receiving Medicaid who were in their second or third trimester of pregnancy. Participants aged 18 to 45 years were recruited from various health care systems located in Ohio. Researchers applied a thematic analysis approach during data collection and data analysis.Results: Two overarching themes emerged about what these African American women considered meaningful when they talked to their prenatal care provider during pregnancy: (1) conversations around my prenatal care and (2) equipping me with knowledge.Conclusion: The results obtained through the application of intersectionality theory allow researchers the opportunity to create effective solutions, interventions, and policies that can be implemented to improve infant health outcomes and reduce the risk of infant mortality among pregnant African American women receiving Medicaid. Implications also suggested that public health practitioners in Ohio should increase their awareness of what is important to this population to build patient's trust in provider recommendations and patient’s confidence in shared decision-making.

Research of beliefs about medicines by BMQ scale and related factors in hypertensive patients

Introduction: Hypertension is a chronic disease that requires regular monitoring and treatment. Medication adherence and medication trust assessment play an important role in understanding the underlying causes and developing solutions to improve treatment outcomes for patients. Objective: To assess medication trust in hypertensive patients and to explore the factors associated with medication trust according to the Beliefs about Medicines Questionnaire (BMQ) scale. Methods: A cross-sectional study was conducted on 607 outpatients with hypertension who visited and received treatment at the University of Medicine and Pharmacy of Hue Hospital from July to November 2022. Results: The mean age of patients was 69.7 ±11 years. The proportion of patients who agreed that taking medication is necessary was 99%. Only 3.1% of patients believed that doctors placed too much trust in medication, and about 5.1% believed that medication was harmful. About 62.8% of patients did not fully understand the medications they were taking. Conclusions: We found that medication trust is closely associated with demographic characteristics, disease-related characteristics, knowledge about hypertension, the provision of health information and treatment medications. Key words: beliefs about Medication, hypertension, BMQ scale

The Impact of Procedural Justice and Trust on Customers' Continuity Intention Toward Healthcare Providers.

As life has become noticeably more comfortable compared to the past, there is a mounting interest in various service sectors, such as healthcare, where growing demand has led to an increase in the number facilities that supply products essential to service provision. Enhancing the service quality is critical to gaining an advantage in the fiercely competitive healthcare environment and is especially important as the outcomes encompass not only the treatment of disease but also patients' emotional and experiential satisfaction. This study presents procedural justice and two dimensions of trust as factors related to physician and patient relationship, investigating their effects on patients' intention to continue the relationship with their healthcare providers. We found that procedural justice had a positive effect on the two dimensions of trust, and the latter had a significant positive effect on the continuity intention. As this study verifies the necessity of procedural justice and trust for patients to continuously experience medical services, it is imperative for the healthcare industry to understand and incorporate these factors into their practices.

Importance Performance Analysis (IPA) of Patient Satisfaction with Fuzzy Logic at the Rumbai Maternity Clinic

This study focuses on the level of patient satisfaction at the Rumbai Maternity Clinic. Quality of service is the main key that influences patient trust and satisfaction with this health facility. Therefore, the purpose of this study was to analyze patient satisfaction with the Importance Performance Analysis (IPA) method using fuzzy logic. This study will identify service attributes that are considered important by patients and evaluate the extent to which patient expectations have been met at the clinic. Attributes studied include cleanliness of facilities, courtesy of medical staff, availability of medicines, quality of medical services, information conveyed to patients, and others. The (IPA) method will help measure the level of importance and performance of each service attribute based on patient perceptions. Fuzzy logic is used to overcome the complexity and subjectivity of assessing patient satisfaction. The results of this study are expected to provide a comprehensive picture of patient perceptions and satisfaction at the Rumbai Maternity Clinic. Clinical management can use the results of this study to identify service improvement priorities and increase patient satisfaction. The scientific contribution of this research lies in combining the IPA method and fuzzy logic in the analysis of patient satisfaction. Thus, this research has the potential to help improve the quality of health services at the Rumbai Maternity Clinic and can be applied as a guide for developing similar methods in other health facilities.

Disentangling trust of patients with rare cancer in their healthcare professionals and the healthcare system: a qualitative interview study.

Patients with a rare cancer face challenges, e.g., delayed diagnosis, that may affect trust in the healthcare system and the healthcare professionals (HCPs) involved. This study aimed to explore trust of patients with a rare cancer in their HCPs and the healthcare system. Semi-structured interviews were conducted with 20 purposively sampled patients with a rare cancer. The interview guide included topics related to trust, including level, development, barriers and facilitators, importance, and trust dimensions. Thematic analysis was conducted with use of Atlas.ti. The mean age of patients was 50years, 60% were female, and 70% were highly educated. Three themes were constructed: (1) "Confirmed expertise is a prerequisite of trust." Patients need confirmation of their HCPs' expertise, as it could not be assumed due to the rarity of their cancer; (2) "Trust depends on the adequacy of information and how it is provided." Limited information about rare cancer reduced patients' trust in health care, whereas interpersonal trust was mainly affected by how HCPs provided information; and (3) "Trust is built on properly coordinated and supportive care." Proper organization and cooperation within and between hospitals, and integration of supportive care, enhanced trust. Patients with a rare cancer experience challenges that influence trust in HCPs and the healthcare system. Further research should examine trust among subgroups of patients with a rare cancer, to enable development of tailored interventions. HCPs may improve trust by focusing on expertise, effective information provision, proper coordination of care, and provision of adequate supportive care.

Factors Facilitating the Perpetration of Medical Identity Theft: A Case of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria

Medical Identity Theft is a pressing concern in healthcare systems, influenced by intricate motivations and vulnerabilities. This study investigates facilitating factorsbehind MIT, uncovers internal vulnerabilities, and proposes mitigation strategies. This study contributes to patient well-being and trust by fostering a secure healthcareenvironment through holistic MIT prevention strategies. A mixed-methods approach was employed, encompassing quantitative and qualitative aspects to explore the perpetration of MIT, Zaria, a significant healthcare institution. The diverse sample of 388 participants, including patients, healthcare providers, and stakeholders, was obtained through stratified random sampling. Structured interviews and questionnaires gathered primary data.Findings showcase a diverse workforce with a mid-career presence and gender distribution in technical roles. Significant facilitating factors for MIT encompassfinancial gain, fraudulent service access, and expense avoidance, necessitating robust patient identification procedures and comprehensive strategies. Internal vulnerabilitiesand inadequate data security underscore the need for enhanced measures, updated systems, and education. Respondents endorse a multifaceted approach, advocatingbiometric identification, authentication, patient photograph display, unique identifiers, access controls, staff training, real-time data verification, audit trails, data encryption,and patient education. Collaboration, awareness, and technology emerge as key elements in safeguarding patient data, ethical healthcare standards, and integrity. Findings advocate a comprehensive approach, emphasizing collaboration, awareness, and technology in addressing MIT

Balancing Privacy and Progress: A Review of Privacy Challenges, Systemic Oversight, and Patient Perceptions in AI-Driven Healthcare

Integrating Artificial Intelligence (AI) in healthcare represents a transformative shift with substantial potential for enhancing patient care. This paper critically examines this integration, confronting significant ethical, legal, and technological challenges, particularly in patient privacy, decision-making autonomy, and data integrity. A structured exploration of these issues focuses on Differential Privacy as a critical method for preserving patient confidentiality in AI-driven healthcare systems. We analyze the balance between privacy preservation and the practical utility of healthcare data, emphasizing the effectiveness of encryption, Differential Privacy, and mixed-model approaches. The paper navigates the complex ethical and legal frameworks essential for AI integration in healthcare. We comprehensively examine patient rights and the nuances of informed consent, along with the challenges of harmonizing advanced technologies like blockchain with the General Data Protection Regulation (GDPR). The issue of algorithmic bias in healthcare is also explored, underscoring the urgent need for effective bias detection and mitigation strategies to build patient trust. The evolving roles of decentralized data sharing, regulatory frameworks, and patient agency are discussed in depth. Advocating for an interdisciplinary, multi-stakeholder approach and responsive governance, the paper aims to align healthcare AI with ethical principles, prioritize patient-centered outcomes, and steer AI towards responsible and equitable enhancements in patient care.

Flourishing, Mental Health Professionals and the Role of Normative Dialogue.

This paper explores the dilemma faced by mental healthcare professionals in balancing treatment of mental disorders with promoting patient well-being and flourishing. With growing calls for a more explicit focus on patient flourishing in mental healthcare, we address two inter-related challenges: the lack of consensus on defining positive mental health and flourishing, and how professionals should respond to patients with controversial views on what is good for them. We discuss the relationship dynamics between healthcare providers and patients, proposing that 'liberal' approaches can provide a pragmatic framework to address disagreements about well-being in the context of flourishing-oriented mental healthcare. We acknowledge the criticisms of these approaches, including the potential for unintended paternalism and distrust. To mitigate these risks, we conclude by suggesting a mechanism to minimize the likelihood of unintended paternalism and foster patient trust.