The importance of trustworthiness: lessons from the COVID-19 pandemic

In a time of myriad threats to the health and well-being of children and their families, pediatricians play a critical role in advancing scientific discoveries, communicating findings to improve public understanding, and integrating evidence into policy and clinical practice. As outlined in the Public Health Code of Ethics, “the effectiveness of public health policies, practices, and actions depends upon public trust gained through decisions based on the highest ethical, scientific, and professional standards.” 1 Multiple urgent issues requiring evidence and advocacy in pediatrics include: (1) inadequate access to primary and subspecialty care, (2) the ongoing coronavirus (COVID-19) pandemic and its associated disruption in education and social services, (3) vaccine confidence, (4) immigration (caring for children and families entering the United States), (5) climate change, (6) environmental toxins, (7) gun violence, and (8) the behavioral and mental health crisis. All of these threats are compounded by racism, social injustice, and inequities in our society and health care system. Moreover, there is a mounting imperative to protect medical science and its integrity in the age of social media and widespread misinformation. We must demonstrate trustworthiness as a requisite condition to foster trust.