As Francis Collins prepared to step down from his 12-year tenure as Director of the National Institutes of Health (NIH), the esteemed genome scientist and celebrated government leader reflected frankly on the failures of the biomedical sciences to win the trust of the American public. In an interview with the New York Times in October of 2021, he described his expectation that Americans were “people of the truth,” and expressed his “heartbreak” at discovering the high levels of unwillingness to accept “accurate medical information” about COVID-19 vaccines.1 Indeed, a February 2022 report by the Pew Research Center found that after decades of expressing a relatively high degree of trust, Americans reporting a “great deal of confidence in scientists” dropped from 39% at the beginning of the pandemic to 29% in November of 2021.2 A report issued two months later explored in depth why trust among “Black Americans” had dropped and found that the main reasons were concerns about abuse within scientific research (e.g., from the United States Public Health Service Study of Untreated Syphilis at Tuskegee) and negative interactions with doctors and health care providers.3

In line with these findings, we argue that public mistrust in science is due substantially to lack of adequate attention to these legacies and ongoing realities of injustice, and not primarily the result of public misunderstanding or miscommunication of scientific procedures and results, as is often assumed. Research initiatives launched in fields as diverse as genomics, neuroscience, and AI too often incorporate concerns with justice and ethics in limited and marginal ways. Scholars with expertise in these domains are typically brought onboard too late in the process to provide meaningful input into decisions about the categories that frame research and the questions and aims that guide it. Instead of helping shape studies so that questions of ethics and justice are substantively engaged from the very beginning, such experts are tasked with helping cope with public implications, miscommunications, and misunderstandings. We introduce below a framework for re-centering questions of ethics and justice in the research process, a realignment that we argue is fundamental to building public trust in science.