Аннотация:Over the last years, the Russian National Health Care System has undergone a number of great
changes. These reforms are motivated by the whole transformation of medicine as a social institute.
As it showed by the numerous studies, under the process of the globalization and new technologies
the clinical practice has been changed. The high technologies in medicine have incorporated new
trends in practice and lead to use exactly hard evidence for diagnosis and treatment. But spending
on new health technology increases healthcare costs. Now the main trend is the standardization of
practice, that is relied on evidence-based medicine as it reduces costs. The great damage to the
physician-patient relationship in these movements is that the patient is considered secondary,
without attention to his individual characteristics and needs. It ignores the individuality and leads
to the uniformity. It affects the doctor-patient relationship. As it well known, trust is a keystone of
effective doctor-patient relationship. It may be considered as a belief of an individual that trustee
will care of his (a patient’s) needs and interests. But, under the modern trends in medicine, there
has been changed the doctor-patient relationship. The paternalistic model has been evolved into the
new form based on a personal informed consent. And now the question is that what role trust plays
now? Based on the data of the sociological research, it was revealed, that over last years, the public
trust to doctors and the national health care system has been unsatisfied and unstable. So, it may
be pointed out, that the informed consent could not be only legal compulsion and defence for doctors
in case of adverse treatment outcome. It is also an ethical obligation as no consent could not be an
insurance for doctors to avoid legal liability. So, mutual trust as a keystone of doctor-patient
relationship has been still actual for the current concept of the social interaction in medical practice.