The Ethics of Vulnerability in Health Care and Clinical Research.
Keywords:
Vulnerability, Informed Consent, Ethics, Health Care, Clinical Research, Patient, PrinciplismAbstract
Vulnerability has traditionally been described as a characteristic of both the individual and the group or the human community. For example, refugees, persons with disabilities and people with serious illness have been considered vulnerable groups. Vulnerability is considered an important notion, but it has proved difficult to define in a theoretically satisfactory and practically useful way. Descriptions of people or groups identified as vulnerable are often either vague or too broad and categorical. In this article, we approach vulnerability from the point of view of principle-based ethics and take a critical view on the ongoing debate. We define vulnerability in a way that solves problems with previous definitions and which can be applied in the context of health care and medical research to avoid abuse and minimize harm. In addition, we formulate a principle of vulnerability which complements the standard mid-level principles of principlism. It defines the obligation for health care operators and researchers to seek to identify the vulnerability of patients and to prevent possible harm to them.
