The lack of public trust in the pharmaceutical sector (i.e. industry, authorities and doctors) could compromise the future of drug development and the regulatory system. Public trust integrates two important components, namely the vulnerability of the truster and the competence of the trustee. Because trust appears to have eroded as a result of drug safety controversies, this paper analyzes the role of public trust during the selective serotonin reuptake inhibitor (SSRI) and suicidality controversy focusing on the aforementioned trust components. Because the competence component of trust is argued to be paramount in determining and maintaining public trust, the SSRI case shows that this component is a part of public trust where these institutions can build on, and might therefore be better used to substantiate and reinforce, public trust. Efforts to build trust should rely on the ethical, professional (competence) and societal commitment of institutions and individuals to protect the vulnerability of the public during controversies. Because shared values can create trust or increase its levels within a specific environment, industry, authorities and physicians ought to develop novel and cooperative strategies to highlight their shared values and motivations. Rules, regulations and settlements are indispensable tools but undue regulation is costly and can backfire on the rather sensitive trust relationships in the pharmaceutical sector.

译文

公众对制药部门 (即行业,当局和医生) 缺乏信任可能会损害药物开发和监管体系的未来。公共信任整合了两个重要组成部分,即委托人的脆弱性和受托人的能力。由于药物安全性争议似乎使信任受到侵蚀,因此本文分析了公众信任在选择性5-羟色胺再摄取抑制剂 (SSRI) 和自杀性争议中的作用,重点是上述信任成分。由于认为信任的能力部分在确定和维持公众信任方面至关重要,因此SSRI案例表明,该部分是公共信任的一部分,这些机构可以在此基础上建立,因此可能更好地用于证实和加强公众信任。建立信任的努力应依靠机构和个人的道德,专业 (能力) 和社会承诺,以在争议中保护公众的脆弱性。由于共享价值观可以在特定环境中建立信任或提高信任水平,因此行业,当局和医生应制定新颖的合作策略,以突出其共享价值观和动机。规则,法规和和解是必不可少的工具,但不当的监管成本很高,并且可能对制药行业中相当敏感的信任关系产生适得其反的影响。

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