Bioethics, Vulnerability, and Protection

Abstract

What makes individuals, groups, or even entire countries vulnerable? And why is vulnerability a concern in bioethics? A simple answer to both questions is that vulnerable individuals and groups are subject to exploitation, and exploitation is morally wrong. This analysis is limited to two areas. First is the context of multinational research, in which vulnerable people can be exploited even if they are not harmed, and harmed even if they are not exploited. The type of multinational research likely to raise the most ethical concerns is that in which the investigators or sponsors are from a powerful industrialised country or a giant pharmaceutical company and the research is conducted in a developing country. Second is the situation of women, who are made vulnerable in cultural settings or in entire countries in which they are oppressed and powerless. In the face of cultural values and practices, or governmental policies, these women suffer serious consequences for their health and even lives. Examples are provided, and it is suggested that in some cases vulnerable individuals can be harmed but not exploited. On the positive side, recent developments reveal a new awareness of exploitation and efforts to enhance the ability of developing countries to protect themselves and their citizens from exploitation at the hands of powerful sponsors of research. In addition, human rights principles are increasingly being used to monitor the actions (or inaction) of governments regarding women's reproductive rights and vulnerability with respect to HIV/AIDS, and to take remedial actions.

The research ethics evolution: From Nuremberg to Helsinki

“…[1] Concerns about the conduct of researchers in healthcare date back to at least the end of the 19th century. [2] Because individuals and groups were being exploited and harmed, the concept of vulnerability steadily gained prominence, [3][4][5][6] with concerns over the participation of vulnerable individuals and groups appearing in national and international policy and guideline documents. [5] With this surfaced the all-too-familiar tensions between scientific progress and societal interests on the one hand and individual rights and interests on the other, regarding the goals of health research.…”

Ethics in clinical research

“…vi. Sensitivity Sensitivity in research implies balancing scientific interest (the research) with general values and norms affecting the human dignity of the people involved 14 . vii.…”

HIV em mulheres de meia-idade: fatores associados

“…A great number of people still do not adopt the use of condom for considering the possibility of contamination unlikely. 25,26 According to Macklin, women are more vulnerable to AIDS due to their social and economic position in society, undermining negotiations on using the preservative, the discussion on fidelity and abandoning risk relations. Feelings of powerlessness and inner conflicts reported by women express a fatalist conception of the disease, against which nothing can be done.…”

“…Feelings of powerlessness and inner conflicts reported by women express a fatalist conception of the disease, against which nothing can be done. 26 Investigating sexuality among heterosexuals in stable relationships must take into consideration moral beliefs and values like love, fidelity, respect, trust, and partnership. 27,28 Nevertheless, the current configuration of the AIDS epidemic confirms the fallibility of this model.…”