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.

Trust in medical science is at a critical crossroads as a result of heightened rhetoric and polarization in politics, the capacity of social media to blur the distinction between truth and fiction, and intensifying concerns about conflict of interest and scientific misconduct.2,3 While Americans reported decreased trust in physicians and the health care system over the last half-century,4 data from a 2019 Pew Research Center survey were promising, suggesting that public confidence in scientists was on the upswing, with levels far exceeding trust in media, business leaders, and elected officials.5 Public confidence in medical scientists was similar to that for scientists overall; 87% reported either a great deal or fair amount of confidence in medical scientists to act in the best interests of the public. Furthermore, there were no partisan differences in views of medical doctors or research scientists, in contrast to environmental scientists where wide political differences emerged. Despite generally positive views about scientists, most Americans remained skeptical about key areas of scientific integrity including transparency about potential conflicts of interest (especially for industry-sponsored research) and accountability for mistakes or misconduct. Importantly, Black and Hispanic respondents were more likely than Whites to see professional or research misconduct as a “very or moderately big problem.”

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