Without trust there is no credible human health research (HHR). This article accepts this truism and addresses a crucial question that arises: how can trust continually be promoted in an ever-changing and uncertain HHR environment? The article analyses long-standing mechanisms that are designed to elicit trust—such as consent, anonymization, and transparency—and argues that these are best understood as trust represented by proxies of trustworthiness, i.e., regulatory attempts to convey the trustworthiness of the HHR system and/or its actors. Often, such proxies (...) are assumed to operate as markers that trust exists or, at least, has not been lost. But, since trust can neither be “built” nor “secured,” this is a precarious assumption. Worryingly, there is no existing theoretical account of how to understand and evaluate these proxies of trustworthiness as part of a trusted HHR ecosystem. To remedy this, the paper argues for a radical reimagining of trust and trustworthiness as performative acts that ought to be understood in relation to each other and by reference to the common values at stake. It is shown that proxies of trustworthiness are the operational tools used to perform trustworthiness. It advocates for a values-based approach to understanding the relationship between trust and trustworthiness. This establishes a strong basis for an evaluative framework for proxies of trustworthiness, i.e., to determine how to perform trustworthiness well. Five common proxies in HHR are scrutinized from a values perspective. The contribution is to provide a far-reaching normative and practical framework by which existing and future proxies of trustworthiness can be identified, assessed, maintained, or replaced in rapidly changing HHR regulatory ecosystems where trust itself is crucial to the success of the entire HHR enterprise. (shrink)

This article explores the discursive behaviour of Chinese local officials in press conferences handling the recent 2015 crisis of Tianjin blasts. Drawing upon the previous analyses on relations of trust and discourse, and on the crucial aspects of trustworthiness, it examines how the officials struggled for trustworthiness discursively, and how their ‘doing’ trustworthiness varied in two phases of crisis communication. The analysis reveals markedly different approaches to the officials’ ‘doing’ trustworthiness in two phases. In the ‘unsatisfactory’ phase, the officials mainly (...) constructed the aspect of expertise, with few expressions conveying integrity and none conveying care; while in the ‘well-handled’ phase, the officials constructed all three aspects. In addition, their discursive strategies of constructing expertise changed from extensively using ‘techs’ to combining ‘techs’ and vernacular language, and those of constructing integrity changed from not saying ‘what lacks evidence’ to providing information with adequate evidence. Effects of different aspects and discursive strategies on trust are also discussed. (shrink)