Vulnerability in research and health care; describing the elephant in the room?

Bioethics 22 (4):191–202 (2008)
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Abstract

Despite broad agreement that the vulnerable have a claim to special protection, defining vulnerable persons or populations has proved more difficult than we would like. This is a theoretical as well as a practical problem, as it hinders both convincing justifications for this claim and the practical application of required protections. In this paper, I review consent-based, harm-based, and comprehensive definitions of vulnerability in healthcare and research with human subjects. Although current definitions are subject to critique, their underlying assumptions may be complementary. I propose that we should define vulnerability in research and healthcare as an identifiably increased likelihood of incurring additional or greater wrong. In order to identify the vulnerable, as well as the type of protection that they need, this definition requires that we start from the sorts of wrongs likely to occur and from identifiable increments in the likelihood, or to the likely degree, that these wrongs will occur. It is limited but appropriately so, as it only applies to special protection, not to any protection to which we have a valid claim. Using this definition would clarify that the normative force of claims for special protection does not rest with vulnerability itself, but with pre-existing claims when these are more likely to be denied. Such a clarification could help those who carry responsibility for the protection of vulnerable populations, such as Institutional Review Boards, to define the sort of protection required in a more targeted and effective manner.

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2009-01-28

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Samia Hurst
University of Geneva

Citations of this work

Why bioethics needs a concept of vulnerability.Wendy Rogers, Catriona Mackenzie & Susan Dodds - 2012 - International Journal of Feminist Approaches to Bioethics 5 (2):11-38.
The concept of vulnerability in medical ethics and philosophy.Joachim Boldt - 2019 - Philosophy, Ethics, and Humanities in Medicine 14 (1):1-8.
Vulnerability: Too Vague and Too Broad?Doris Schroeder & Eugenijus Gefenas - 2009 - Cambridge Quarterly of Healthcare Ethics 18 (2):113.
Vulnerability as a key concept in relational patient- centered professionalism.Janet Delgado - 2021 - Medicine, Health Care and Philosophy 24 (2):155-172.
The concept of vulnerability in medical ethics and philosophy.Joachim Boldt - 2019 - Philosophy, Ethics, and Humanities in Medicine 14 (1):1-8.

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