A friend sent me a video on WhatsApp. A frightened, restless kitten is seen in a protected shelter defending itself by attacking another cat. This other cat makes various attempts to approach: its movements are calm and gentle; it repeatedly narrows its eyes and pulls back to avoid the kitten’s swipes, but after some time, it lies down peacefully next to the kitten. The kitten, in the meantime, also calms down and moves closer; in the end, it lies down beside the cat, soothed. Their bodies touch, sharing warmth: the kitten looks ahead, while the cat turns its head gently towards the small one. The caption reads: “Kitten rescued, abused by former owners; adoptive mother knows exactly how to gain her trust.” The amount of time that passes is unclear, but it is evident that more than the one-minute length of the video elapses from the opening scene to the final one: all the time required – and neither of the protagonists seems to be in any hurry – to “gain”, or perhaps better, “establish”, mutual trust. This idyllic scene shared through modern technology and closely linked to the idea of “taming”, offers some thought-provoking insights into care and trust in human relationships.

Indeed, it provides indications of the style and method of interaction that can easily be applied to human relationships. Consider, for instance, the bond between parents and children: the adoption of a minor “in a state of abandonment” is perhaps the closest analogy to this story (especially when the child has suffered abuse), but one could also think of situations where a parent has died and a shared grieving process is needed, or where a biological parent reconnects with their child after the other had abandoned them. Equally, it may involve a daughter who has distanced herself from her family, ended up in difficult circumstances, and is allowed to reconnect with her parents. Another, perhaps more “challenging”, scenario concerns those who find themselves caring for an ageing parent who has become dependent.

This model may also be applied to other caregiving relationships based on proximity. In legal terms, the concept of “natural” or “de facto” caregivers is sometimes used to describe situations where someone, without any legal obligation and out of solidarity, chooses to care for another in severe difficulty. To explore this further, we might shift our attention from the two cats to the relationships formed between another well-known friend of many “grandes personnes” – the Little Prince – and the characters in the famous “children’s book”: not only the fox, but also the aviator, the rose, and ultimately the snake. Each of these connections involves vulnerability and precariousness experienced by one or both individuals.

In these different instances of vulnerability, the meaning – or potential meaning – of “care and trust” becomes clear. Genuine care and trust can arise only when the struggles, timing, needs, and even unusual demands of the other are accepted. Furthermore, these qualities become reciprocal over time: while it is true that one person expresses a need and the other offers support if the relationship is appropriately formed and maintained, both will experience its burdens and benefits.

Can this “beneficial” model of human relationships also apply to professional relationships?

Important differences must be acknowledged.

A professional to whom someone turns for care has obligations deriving from the social mandate that legitimises their role: from social professions, where care is perhaps a more obvious element1, to the healthcare and social care professions, now significantly expanded and reorganised by Law no. 3/2018 (the so-called “Lorenzin” law), which includes psychology among the health professions.

This type of relationship is also marked by a particular asymmetry of information. This asymmetry does not only concern the professional’s specialised knowledge (regarding social services, medicine, nursing, psychology, physiotherapy, etc.), but also the knowledge that the person seeking help has about themselves – their personal values, worldviews, life expectations, current suffering, and familial and social context.

This asymmetry can sometimes lead to a reductive view of the professional relationship, focused solely on the service provided, and may overlook its broader care-oriented purpose. Ultimately, the goal remains the person’s “care”, and the relationship must be based on mutual respect and trust, to be earned, built, and reaffirmed over time and in step with the relationship’s rhythm.

While this “service-oriented drift” is possible – and partly understandable given the organisation of care services (especially the National Health Service, but not only) and certain legal tools that flatten the relationship into a series of “essential levels of care” understood as “minimal” – this is, nonetheless, a regrettable and legally unfounded deviation2.

I would like to briefly touch upon two legal references which, in my view, merit further consideration. These concern the healthcare context, where, due to the current strain on the welfare state, it is often hardest not only to realise, but even to expect, adequate relationships of care and trust from either main party: the provider or the recipient of care (for themselves or a loved one).

The first reference is drawn from a judgment of the Council of State (no. 4460/2014), renowned for ruling on the well-known Englaro case3, several years after Eluana’s death.

This was a landmark ruling because it followed a legal journey that involved not only Eluana and her parents – especially her father and legal guardian, who interpreted her wishes, needs, and aspirations and exercised the “powers” (and “duties”) of care4 – but also the judiciary, scientific community, and the wider public discourse. For this reason, the jurisprudence developed from this and similar difficult cases has profoundly influenced current legal developments.

The judges defined “healthcare provision” aligned with a “modern welfare-oriented administrative law”. It is described as a “complex positive action that ranges from welcoming the patient to understanding their needs and requirements, from listening to their requests to diagnosing the condition, from the doctor–patient encounter to jointly developing a therapeutic strategy, from obtaining informed consent to carrying out the agreed treatment – all in the pursuit of a path that is, above all, existential rather than merely curative, within the healthcare facility, and centred on the patient’s identity, personhood, and psycho-physical wellbeing.” 5 As we can see, this model is not far removed from the one illustrated at the beginning of this reflection.

This model has been formally adopted by a subsequent national law, Law No. 219 of 22 December 2017, titled “Provisions regarding informed consent and advance directives”, which is the second legal reference I wish to highlight. I will quote it directly here and may return to some of its aspects in future analyses 6.

Article 1 of this law states:

• Paragraph 2: “The care relationship and trust between patient and physician is promoted and valued. It is based on informed consent in which the patient’s decision-making autonomy and the physician’s expertise, professional autonomy and responsibility come together. Healthcare professionals forming part of the care team also contribute to this relationship, by their respective competencies. If the patient so wishes, their family members, civil union partner, cohabitant or a trusted person may also be involved.”
• Paragraph 5: “[…] Should the patient express the will to forego or refuse treatment necessary for survival, the physician shall inform the patient and, with their consent, their family, of the consequences of this decision and any possible alternatives, and promote all actions to support the patient, including through psychological support services. […]”
• Paragraph 6: “The physician must respect the patient’s wish to refuse or forego treatment and, as a result, is exempt from civil or criminal liability. The patient cannot demand treatments that are against the law, professional ethics, or good clinical practice; in such cases, the physician has no professional obligation.”

These seem to be valuable guidelines for defining the scope of the care relationship and for clarifying the essential elements of the shared “universe” where care seekers and providers meet, and what mutual respect entails.

Paragraphs 8 to 10 of the same article are also crucial, as they concern the organisational dimension that makes such a relationship of care and trust possible:

• “Communication time between doctor and patient constitutes care time.”

Every healthcare facility, public or private, shall guarantee, through its organisational arrangements, the full and correct implementation of the principles of this law, ensuring that patients are properly informed and that staff receive appropriate training.

Initial and continuing education for physicians and other healthcare professionals shall include training in patient communication and relationships, pain therapy, and palliative care.”
Once again, we see a relational horizon that strongly resembles the one described at the outset.
A final, somewhat bitter, reflection: this is a national law, meaning it represents the goals we, as a society, have chosen for ourselves. Perhaps these goals were considered sensible and “good” because, as reflected in parliamentary debates and illustrated by the examples that inspired this piece, they serve to guide professional relationships towards the promotion of health – understood as physical, psychological, and social wellbeing. Legal language is prescriptive by nature, though increasingly interpreted in practice as merely advisory. If the law is no longer able to “do things with words”, then this is a problem we must all face – as legal subjects, and therefore as agents in both the public and private dimensions of their implementation.