Trust is identified by medical ethicists as a fundamental value in medicine.  It is typified by the doctor-patient relationship, in which a patient’s trust in her physician is essential for effective communication and conducive to shared ethical responsibility for choices and outcomes.  Telecare, the practice of medicine using information and communication technology to monitor and treat patients at home, redefines the relationship between patient and clinician and moves health care to a new context.  It promises to reduce health care costs and produce better outcomes, but it also impacts patient trust.

This study aims to find out how chronically ill patients establish trust in telecare, and when this trust is well-grounded.  Patients, clinicians and designers associated with two private companies will be interviewed, and an extensive database of existing patient survey data will be analyzed.  An ethical framework will be used to analyze the expectations and reasons grounding trust attitudes among chronically ill telecare patients.

Although there have been substantial studies in science and technology studies of the new rhetoric, routines, and roles that accompany telecare, these studies have not yet been brought to bear on policy, medical ethics, and the ethics of technology design.  The present study provides a bridge between the theoretical understanding of telecare and the societal evaluation of telecare in terms of concepts such as responsibility, privacy, legitimacy, autonomy, freedom, and independence.  It also generates preliminary recommendations for technology and human interface design of future telecare applications both in the Netherlands and abroad.