Trusting vs Trustworthiness of Physicians and Medical Profession
There has been concern in the medical community for some time that African-Americans and other minorities distrust the medical profession. This concern has raised questions as to whether this distrust and the documented history of past research abuse such as in the Tuskegee Syphilis Study is also reflected in lesser numbers of African-Americans or other minorities willing to participate in health research clinical trials thus impairing the universal validity of the trial results. If true, another consequence might be possibly denying the direct benefits of the trials or the trial results to those racial and ethnic groups.
A literature search by David Wendler and others was published in the Open Access internet medical journal PloS Medicine, February 2006 titled “Are Racial and Ethnic Minorities Less Willing to Participate in Health Research?” Their conclusion was:
“We found very small differences in the willingness of minorities, most of whom were African-Americans and Hispanics in the US, to participate in health research compared to non-Hispanic whites. These findings, based on the research enrollment decisions of over 70,000 individuals, the vast majority from the US, suggest that racial and ethnic minorities in the US are as willing as non-Hispanic whites to participate in health research. Hence, efforts to increase minority participation in health research should focus on ensuring access to health research for all groups, rather than changing minority attitudes.
In the May 2006 issue of the same PloS Medicine, Matthew K. Wynia and Vanessa Northington Gamble respond suggesting that unwarranted conclusions were made by Wendler and others in their paper. Though Wynia and Northington disagree with the analysis and conclusion that "racial and ethnic minorities in the US are as willing as non-Hispanic whites to participate in health research",they add:
“Despite these scientific weaknesses, Wendler et al. are right to conclude that it is inappropriate to focus on changing African Americans' attitudes of mistrust, but not because those attitudes don't exist. Many minorities don't feel welcome and respected within the health-care system. Those who do come in have already crossed a threshold of trust, at least with their individual doctor. Those who don't come in, of course, will never have the opportunity to be asked to enroll in a clinical trial. Instead, the reason it would be inappropriate to focus on changing patient attitudes is because these attitudes of mistrust are based on a history of untrustworthy behavior by the health professions, which must be acknowledged and rectified. In other words, the medical profession should not focus on making minorities be more trusting; we should focus on ensuring that we are becoming trustworthy.”
I would be interested to know the general attitude of those visitors to my blog who are other than “non-Hispanic whites” regarding trust in physicians and the medical profession. ..Maurice.