Hastings Cent Rep. 2022 Mar;52 Suppl 1:S12-S17. doi: 10.1002/hast.1361.
In this article, I offer a preliminary exploration of the heavy lifting that the word "trust" is doing in questions about Black distrust of medicine and what, if anything, comes from it. I also offer an account of why questions like, "Why don't Black people trust vaccines?" are not only the wrong questions to ask but also insulting, and I go on to provide a Black feminist analysis of racial injustice in medicine-an analysis that does not center a notion of trust. I begin by arguing that implicit in these questions is a pathologizing of Black people-the idea that there is something wrong with Black people rather than something wrong with the conditions within which Black people exist. The sense that there is something wrong with Black people both further disadvantages them and ignores the role that health care institutions have played and continue to play in fostering a climate of distrust. I show that even attempts to explain distrust fail to adequately capture the harms committed against Black people, even if such efforts gesture at institutional responsibility. I sketch out what is important about trust but also briefly discuss why trust may not be the answer to the problems that Black people face in health care encounters.
在本文中,我初步探讨了“信任”一词在黑人对医学的不信任问题中所承担的重要责任,以及由此产生的影响。我还解释了为什么像“为什么黑人不信任疫苗?”这样的问题不仅是错误的,而且是侮辱性的,并进一步提供了一种黑人女性主义的医学领域种族不公正分析——这种分析不将信任概念作为核心。我首先认为,这些问题隐含着一种将黑人病态化的观念,即黑人本身存在问题,而不是他们所处的环境存在问题。这种认为黑人有问题的观念不仅进一步使他们处于不利地位,而且忽视了医疗保健机构在助长不信任氛围方面所扮演的角色和继续发挥的作用。我表明,即使试图解释不信任,也未能充分捕捉到针对黑人的伤害,即使这些努力表明了机构的责任。我勾勒出信任的重要性,但也简要讨论了为什么信任可能不是解决黑人在医疗保健遭遇中面临的问题的答案。