Hastings Cent Rep. 2020 Jan;50(1):27-29. doi: 10.1002/hast.1081.
Medical mistrust has a well-documented harmful impact on a range of patients' health behaviors and outcomes. It can have such egregious downstream effects on so many aspects of medicine-from clinical trial participation to health care use, timely screening, organ donation, and treatment adherence-that it is sometimes described as one of the social determinants of health. In the article "Trust, Risk, and Race in American Medicine," Laura Specker Sullivan makes the compelling case that trust is essential to building a therapeutic alliance in which effective, high-quality health care can be delivered and received. As a complement to her suggestion that health care providers take an active role in mitigating mistrust by demonstrating "not only their capacity to be honest and forthright but also their ability to respond to the potential truster's needs," we recommend that key health care professionals commit to five actions.
医学领域的不信任现象有大量文献记录证明会对患者的一系列健康行为和结果产生有害影响。它可能会对医学的许多方面产生如此恶劣的下游影响——从临床试验参与到医疗保健的使用、及时筛查、器官捐赠和治疗依从性等——以至于它有时被描述为健康的社会决定因素之一。在《美国医学中的信任、风险和种族》一文中，Laura Specker Sullivan 提出了一个令人信服的观点，即信任对于建立治疗联盟至关重要，在这种联盟中可以提供和接受有效、高质量的医疗保健。作为对她的建议的补充，即医疗保健提供者通过展示“不仅有诚实坦率的能力，而且有能力回应潜在信任者的需求”，主动减轻不信任感，我们建议主要的医疗保健专业人员承诺采取以下五项行动。
