ICTs, personal data, digital rights, the GDPR, data privacy, online security… these terms, and the concepts behind them, are increasingly common in our lives. Some of us may be familiar with them, but others are less aware of the growing role of ICTs and data in our lives - and the potential risks this creates. These risks are even more pronounced for vulnerable groups in society. People can be vulnerable in different, often overlapping, ways, which place them (...) at a disadvantage to the majority of citizens; Table 3 in this guide presents some of the many forms and causes of vulnerability. As a result, vulnerable people need greater support to navigate the digital world, and to ensure that they are able to exercise their rights. This guide explains where such support can be found, and also answers the following questions: - What are the main ethical and legal issues around ICTs for vulnerable citizens? - Who is vulnerable in Europe? - How do issues around ICTs affect vulnerable people in particular? This guide is a resource for members of vulnerable groups, people who work with vulnerable groups, and citizens more broadly. It is also useful for data controllers1 who collect data about vulnerable citizens. While focused on citizens in Europe, it may be of interest to people in other parts of the world. It forms part of the Citizens’ Information Pack produced by the PANELFIT project, and is available in English, French, German, Italian and Spanish. You are welcome to translate this guide into other languages. Please send us a link to online versions in other languages, so that we can add them to the project website. (shrink)

Persuasive technologies for health‐related behaviour change give rise to ethical concerns. As of yet, no study has explicitly attended to ethical concerns arising with the design and use of these technologies for vulnerable people. This is striking because these technologies are designed to help people change their attitudes or behaviours, which is particularly valuable for vulnerable people. Vulnerability is a complex concept that is both an ontological condition of our humanity and highly context‐specific. Using the (...) Mackenzie, Rogers and Dodds’ taxonomy of vulnerability, this paper identifies (a) the wrongs or harms to which a person is vulnerable, (b) the source of this vulnerability, and (c) the safeguards needed in response. Two ethical concerns with the design of persuasive technology for vulnerable people are discussed: the concerns of taking into account users' interests and their autonomy. (shrink)

Phenomenological healthcare research should include the lived experiences of a broad group of healthcare users. In this paper it is shown how shadowing can give a voice to people in vulnerable situations who are often excluded from interview studies. Shadowing is an observational method in which the researcher observes an individual during a relatively long time. Central aspects of the method are the focus on meaning expressed by the whole body, and an extended stay of the researcher in (...) the phenomenal event itself. Inherent in shadowing is a degree of ambivalence that both challenges the researcher and provides meaningful insights about the phenomenon. A case example of a phenomenological study on the experiences of elderly hospital patients is used to show what shadowing yields. (shrink)

The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about (...) the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a ‘report’ button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them. (shrink)

The Mental Capacity Act 2005 gives statutory force to the common law principle that all adults are assumed to have capacity to make decisions unless proven otherwise. In accord with best practice, this principle places the evidential burden on researchers rather than participants and requires researchers to take account of short-term and transient understandings common among some research populations. The aim of this paper is to explore some of the implications of the MCA 2005 for researchers working with 'vulnerable' (...) populations in health and social care settings. The Cyclical Consent Model is described and offered as a process by which researchers might develop good practice when engaged in research involving vulnerable people. (shrink)

Stoicism deserves everything that Broic$ are doing to its movement. This is because Stoics stuff the value of everything into their own heads, thus denying that external things are good and that other people have intrinsic value. Stoics are psychopathic narcissists and axiological solipsists. And this makes Stoicism easy to coopt into bro-y, shallow, self-help-y garbage.

One underappreciated aspect of the practice of nonviolence and just peace is the imperative for the Church to welcome those on the margins, including children and adults with physical and/or intellectual impairments who are vulnerable to dehumanization. Too many children and adults with impairments and their families have not been fully welcomed as sisters and brothers in their local parish. Catholics can draw on a rich theology of peacebuilding in Scripture, Tradition, and Church teaching to respond to these vulnerabilities. (...) Such ongoing transformation is a sign that the Church is being built up in peace and offers a model of communion among a diversity of people. (shrink)

Downie and Schuklenk1 provide a clear narrative of the development of Canadian policy on medically assisted dying. This is very helpful for considering specific aspects of the continuing deliberations in Canada. This commentary presents an alternative perspective on the authors’ argument that narrow eligibility criteria for medical assistance in dying are discriminatory and unjustified. I argue that disability or mental illness as sole reason for accessing MAiD removes protections for all people who have times in their life when they (...) have mental illness or disability combined with intolerable suffering. I claim that individuals do not make their best, self-actualising decisions at those times and the supposed protections of vague terms such as incurable, advanced and decline are not clinically useful for evaluating eligibility for individuals with chronic health conditions. Within discussion of the impact of social determinants of health on access to MAiD, the authors present the argument that decisionally capable people with mental illness or disabilities as their sole underlying condition should be allowed to access MAiD. The authors state that opposing this access sacrifices patient rights and strips people of their agency. To support their argument, they embrace the idea that people with mental illness or disabilities belong to an identifiable cohort. They claim that …. (shrink)

In recent years, healthcare ethics, international law, and political philosophy have been moving closer together. The previously missing links are considerations of justice and their recognition through legal instruments. The most obvious example to date is the topic of benefit sharing.

Older people are confronted with a myriad of challenges throughout the course of their lives in the present society. One of these is the issue of suicidal behaviour among people of older age. This article understands the nature and examines the cause of mortality due to suicide among older people in later life. The author has applied the document analysis method. The information for the current research has been collected using the news content of various Indian newspapers, (...) magazines, and news portals. The researcher was collated 60 occurrences of old-age suicide from the newspapers of Northern Indian states from March 2022 to June 2022. The study has indicated that there is a substantial rise in old-age suicide due to the vulnerable condition of older people in late life. Moreover, the vulnerable condition of older people has led to various factors instrumental in old-age suicide, such as abuse in the family, chronic diseases, depression, poverty, and social rejection that give rise to feelings of committing suicide among the older people. (shrink)

The early coronavirus disease 2019 (COVID‐19) outbreak inflicted vulnerability on individuals and societies on a completely different scale than we have seen previously. The pandemic developed rapidly from 1 day to the next, and both society and individuals were put to the test. Older people's experiences of the early outbreak were no exception. Using an abductive analytical approach, the study explores the individual experiences of vulnerability as described by older people hospitalised with COVID–19 in the early outbreak. In (...) these older people, we found that the societal context and the individual experiences of vulnerability were inextricable linked. The study demonstrates that despite significant individual stress, informants displayed an interesting ability to also view their situation to reorient their perspective. The experience of vulnerability is both conditional and individual, which imposes a degree of unpredictability that neither they nor others were able to negotiate. The article discusses the phenomenon of unpredictability in light of a modern society with regard to how individuals and society may encounter unexpected events in the future where the potential to reorient will be vital. (shrink)

Due to impaired communication, people with aphasia are often in a vulnerable situation and face barriers in accessing health information. This article discusses the contributions ofaugmentative and alternative communication for people with aphasia in optimizing communication, improving language recovery, and mainly in providing education and increasing access to healthinformation. This can be translated into a positive impact on respect for autonomy right, well-being, quality of life, and health outcomes (further participation in the decision-making process, involvement,independence, and control (...) of the rehabilitation process). Health professionals, including nurses, must have communication skills to communicate effectively with this population and also be prepared to useaugmentative and alternative communication strategies. (shrink)

Research concerning work on caring for older people shows that care providers experience a variety of consuming emotions and stress. They can be said to be in a vulnerable position. It is not known, however, how the care providers themselves understand vulnerability. The aim of this study was to illuminate the meaning of vulnerability to care providers caring for older people. A qualitative interpretive approach was adopted. Data were collected through tape-recorded interviews with 16 female registered and (...) practical nurses who were experienced in caring for older people. Qualitative analysis resulted in one core theme and six themes with subthemes. The core theme showed that, for the participating nurses, vulnerability essentially meant being human. The meanings of being human were illustrated by the six themes: having feelings; experiencing moral indignation; being harmed; having courage; protecting oneself; and maturing and developing. Analysis showed that vulnerability was a resource as well as a burden. (shrink)

The elderly are often considered a vulnerable group in public and academic bioethical debates and regulations. In this paper, we examine and challenge this assumption and its ethical implications. We begin by systematically delineating the different concepts of vulnerability commonly used in bioethics, before then examining whether these concepts can be applied to old age. We argue that old age should not, in and of itself, be used as a marker of vulnerability, since ageing is a process that can (...) develop in a variety of different ways and is not always associated with particular experiences of vulnerability. We, therefore, turn to more fundamental phenomenological considerations in order to reconstruct from a first person perspective the intricate interconnections between the experiences of ageing and vulnerability. According to this account, ageing and old age are phenomena in which the basic anthropological vulnerability of human beings can manifest itself in an increased likelihood of harm and exploitation. Thus, we plead for a combined model of vulnerability that helps to avoid problems related to the current concepts of vulnerability. We conclude first that old age as such is not a sufficient criterion for being categorized as vulnerable in applied ethics, and second that reflections on ageing can help to develop a better understanding of the central role of vulnerability in human existence and in applied ethics. (shrink)

Journal of Global Ethics, Volume 9, Issue 3, Page 293-310, December 2013.

There is a growing resurgence in the study of psychedelic medicines for the treatment of mental health and substance use disorders. However, certain early investigations are marred by questionable research methods, abuses against research participants, and covert Central Intelligence Agency financial involvement. The purpose of this study was to understand how and to what extent people of colour and other vulnerable populations, specifically, individuals who were incarcerated or incapacitated due to mental health issues, were exploited during the first (...) wave of psychedelic research in the USA. To do so, we reviewed available empirical publications according to current ethical standards. Variables of interest included race and ethnicity of participants, population vulnerability, drug administration conditions, informed consent and undue influence. Our findings draw attention to the history of research abuses against people of colour in Western psychedelic research. In light of these findings, we urge a call-to-action to current psychedelic researchers to prioritise culturally inclusive and socially responsible research methods in current and future studies. All data relevant to the study are included in the article. (shrink)

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. Second is the situation (...) of women, who are made vulnerable in cultural settings or in entire countries in which they are oppressed and powerless. (edited). (shrink)

Unethical behavior among university students such as cheating and plagiarism has weakened the character of honesty in education. This fact has challenged those who perceived education as a holistic process of internalizing values and norms that lead to the formation of students’ moral principles and moral behavior. Educators have played the role of ensuring the students to internalize and realized moral values and norms. A study of 360 students of the second semester who enrolled at the course of “ethical and (...) personal development” at Atma Jaya Catholic University in Indonesia showed that unethical behavior such as cheating and plagiarism were rarely done. However, a deep look at the reason the students did academic dishonesty has prompted the permissiveness of student’s moral life. This study proves that academic integrity among university students is worrisome, and it is worsened by the fact that they were enrolled in the course of “ethical and personal development”. Seriously taking into consideration the strong desire of students to change the culture of academic misconduct, the authors argue that an educational model which is not oriented excessively to cognitive performance is needed. The authors argue that this position has to be practiced in line with the involvement of “clean” students who are involved as role models in influencing the formation of student awareness and ethical behavior. (shrink)

Several foundational documents of bioethics mention the special obligation researchers have to vulnerable research participants. However, the treatment of vulnerability offered by these documents often relies on enumeration of vulnerable groups rather than an analysis of the features that make such groups vulnerable. Recent attempts in the scholarly literature to lend philosophical weight to the concept of vulnerability are offered by Luna and Hurst. Luna suggests that vulnerability is irreducibly contextual and that Institutional Review Boards (Research Ethics (...) Committees) can only identify vulnerable participants by carefully examining the details of the proposed research. Hurst, in contrast, defines the vulnerable as those especially at risk of incurring the wrongs to which all research ethics participants are exposed. We offer a more substantive conception of vulnerability than Luna but one that gives rise to a different rubric of responsibilities from Hurst's. While we understand vulnerability to be an ontological condition of human existence, in the context of research ethics, we take the vulnerable to be research subjects who are especially prone to harm or exploitation. Our analysis rests on developing a typology of sources of vulnerability and showing how distinct sources generate distinct obligations on the part of the researcher. Our account emphasizes that the researcher's first obligation is not to make the research participant even more vulnerable than they already are. To illustrate our framework, we consider two cases: that of a vulnerable population involved in international research and that of a domestic population of people with diminished capacity. (shrink)

People in extraordinary situations are vulnerable. As research participants, they are additionally threatened by abuse or exploitation and the possibility of harm through research. To protect people against these threats, informed consent as an instrument of self-determination has been introduced. Self-determination requires autonomous persons, who voluntarily make decisions based on their values and morals. However, in nursing research, this requirement cannot always be met. Advanced age, chronic illness, co-morbidity and frailty are reasons for dependencies. These in turn (...) lead to limited abilities or opportunities for decision-making and self-determination. Exclusion of vulnerable people from research projects would disadvantage them by not covering their needs, which would violate the ethical principles of justice and beneficence. Commonly, vulnerability is attributed to social groups. The consequence for individuals, attributed as belonging to such a vulnerable group, is that the principles of respect for autonomy, justice and beneficence are subordinated to the principle of non-maleficence, understood as avoiding the risk to cause more harm than good. In addition, group-specific attribution could lead to stigmatizing because labelling a person as deviation from a norm violates integrity. For clinical nursing research, the question arises how the protection of vulnerable people could be granted without compromising ethical principles. The concept of relational ethics provides a possible approach. It defines vulnerability as the relation between a person’s health status and the extent to which this person is dependent on the researcher and the research context. Vulnerability is not attributed solely to a person but to a situation, meaning the person is viewed in context. By combining vulnerability as a context-related and situational concept with existing approaches of informed consent, the different ethical principles can be balanced and preserved at every step of the research process. (shrink)

Vulnerability is a broad concept widely addressed in recent scholarly literature. Lesbian, gay, bisexual, and transgender people are among the vulnerable populations with significant disadvantages related to health and the social determinants of health. Medical ethics discourse tackles vulnerability from philosophical and political perspectives. LGBT people experience several disadvantages from both perspectives. This article aims to justify the right to health for LGBT people and their particular claims regarding healthcare because they belong to a vulnerable (...) group. Rawls’ theory of justice and Norman Daniels’ normal functioning approach will be discussed in this context. Despite the fact that the right to health can be justified by Daniels’ normal functioning approach, there is still a theoretical gap in justifying the right to health for particular vulnerable populations such as LGBT peopleand discussing society’s duty to compensate for these disadvantages. In search of solid theoretical grounds for the justification of the right to health for LGBT people, the present author takes the opportunity to utilize Daniels’ flexible definition of normal functioning to show that normal functioning not only varies by age but also by different states of human existence, including sexual orientation and gender identity, and to propose replacing the life span approach with normal states of human existence. (shrink)

?Vulnerability? is now a popular term in the lexicon of every-day life and a notion frequently drawn upon by policy-makers, academics, journalists, welfare workers and local authorities. This essay explores some of the ethical and practical implications of ?vulnerability? as a concept in social welfare. It highlights how ideas about vulnerability shape the ways in which we manage and classify people, justify state intervention in citizens? lives, allocate resources in society and define our social obligations. The lack of clarity (...) and limited analysis of the concept of ?vulnerability? in welfare arenas is highlighted as concerning, particularly given that those seen as most in need of support seem to be implicated in commonly held views about ?the vulnerable?. I argue that far from being innocuous, ?vulnerability? is so loaded with political, moral and practical implications that it is potentially damaging to the pursuit of social justice. Two opposing presentations of the notion are set out in order to illustrate that ?vulnerability? is a concept that should be handled with more care. (shrink)

The contemporary emphasis on vulnerability and interdependence stresses the ethical necessity of a critical care concept to undermine the individualistic paradigm of autonomy and the modern understanding of well-being regarding individual self-achievement and world mastery. This paper analyzes how the philosophical investigation of vulnerability has led to an existential, social, and ethical reflection that brought to light a fundamental interdependence among living beings. This chapter examines the nature of this interdependence and the type of relations involved in these dynamics. The (...) author argues that caring for the living involves a holistic approach of the human being that considers not only the plurality of her interpersonal relations but also her relation to the environment and her relation to her ‘self’ as a person with rights and responsibility. Moreover, speaking of interdependence also implies examining the philosophical understanding of our modern concepts of nature and culture along the lines of a philosophical critique of the immunity paradigm and cultural biology anew. Drawing on phenomenological ethics, this chapter shows that the concept of responsibility that stems from this renewed understanding of interdependence implies an ethics based on responsiveness and responsibility that articulates the dignity of human beings as persons with the care for the living they demonstrate in the ‘forms of life’ they inhabit with others. It bears consequences for contemporary issues in bioethics, such as caring for vulnerable people or determining the moral standing of our relations. (shrink)

Pluralism and diversity are largely bound to a humancentric conception of difference, one which fails to consider the plurality of ontologies that constitute reality. The result has been the confinement of the subject of justice to social spaces, and hence the reinforcement of the dichotomous understanding of humanity and nature. This is in part because pluralist theories are largely concerned with one single manifestation of vulnerability: the vulnerability of minority groups. This essay begins by offering a distinctive definition of vulnerability, (...) one that is broad enough to incorporate both universal and dispositional accounts, while being narrow enough to rule out both vitalist and biocentric approaches. I use the notion to examine debates on political pluralism, and I argue that, as they currently stand, pluralist approaches are ill suited for understanding the struggles of Indigenous peoples against colonialism. I defend the view that the normative case for pluralism needs to be grounded in an ecologically aware ethics that can respond to the vulnerability of animate beings who sustain life. (shrink)

This paper advances a new criterion of a vulnerable population in research. According to this criterion, there are consent-based and fairness-based reasons for calling a group vulnerable. The criterion is then applied to the case of people with serious illnesses. It is argued that people with serious illnesses meet this criterion for reasons related to consent. Seriously ill people have a susceptibility to “enticing offers” that hold out the prospect of removing or alleviating illness, and (...) this susceptibility reduces their ability to safeguard their own interests. This explains the inclusion of people with serious illnesses in the Belmont Report’s list of populations needing special protections, and supports the claim that vulnerability is the rule, rather than the exception, in biomedical research. (shrink)

Canada is six years into a new era of legalized medical assistance in dying (MAiD). The law continues to evolve, following a pattern in which Canadian courts rule that legal restrictions on eligibility for MAiD are unconstitutional and Parliament responds by gradually expanding eligibility for MAiD. The central tension underlying this dialogue between courts and government has focused on two conceptions of how to best promote and protect the interests of people who are vulnerable by virtue of intolerable (...) and irremediable suffering due to an illness, disease, or disability. Do we, as a society, have a duty to protect vulnerable people from seeking certain medical procedures that are contrary to their interests, as those are perceived by others? Or do we have a duty to uphold their rights to autonomy, including the right to make choices within a range that may be constrained by many factors, some of which may be socially unjust? This is a recurrent problem in bioethics and medical law, which we explore through the lens of how Canadian courts and Parliament have grappled with defining eligibility for MAiD. (shrink)

Social epistemologists should be well-equipped to explain and evaluate the growing vulnerabilities associated with filter bubbles, echo chambers, and group polarization in social media. However, almost all social epistemology has been built for social contexts that involve merely a speaker-hearer dyad. Filter bubbles, echo chambers, and group polarization all presuppose much larger and more complex network structures. In this paper, we lay the groundwork for a properly social epistemology that gives the role and structure of networks their due. In particular, (...) we formally define epistemic constructs that quantify the structural epistemic position of each node within an interconnected network. We argue for the epistemic value of a structure that we call the (m,k)-observer. We then present empirical evidence that (m,k)-observers are rare in social media discussions of controversial topics, which suggests that people suffer from serious problems of epistemic vulnerability. We conclude by arguing that social epistemologists and computer scientists should work together to develop minimal interventions that improve the structure of epistemic networks. (shrink)

Traditional accounts of vulnerability tend to label entire populations as vulnerable. This approach is of limited utility. Instead, this article utilizes a layered approach to vulnerability, identifying multiple vulnerabilities that older people experience. It focuses on distinguishing the different layers of vulnerability that may be experienced by the elderly in middle-income countries of Latin America. In doing so, I show how the layered approach to vulnerability functions, and demonstrate why it is more interesting and useful than the traditional (...) approach. The article achieves three things. First, it unwraps the different potential layers of vulnerability that develop in old age and the multidimensionality aspects of aging. Second, it reestablishes the usefulness of the concept of vulnerability and explains its functioning. Finally, it shows how different policies can be designed in order to address each vulnerability layer. The layered account promotes a multifaceted approach to public policy analyses and design. In this sense, the layered concept of vulnerability is an appealing concept to consider in public health ethics. (shrink)

Human beings are essentially vulnerable in the view that their existence qua humans is not given but construed. This vulnerability receives basic protection from the State, expressed in the form of the universal rights all citizens are meant to enjoy. In addition, many individuals fall prey to destitution and deprivation, requiring social action aimed at recognising the specific harms they suffer and providing remedial assistance to palliate or remove their plights.Citizens receive protection against their biologic vulnerability by means of (...) an in rem right to health [care], which is more an attitude of protection than a specific programme. When individuals become susceptible, that is, biologically weak or diseased, they also increase their predisposition to additional harm, and require social actions to treat their demeaned condition. Such assistance takes the form of positive healthcare rights.Research on human beings has been slow to observe that the subjects recruited are susceptible, especially so if research is done in less developed countries. By mislabelling them as vulnerable – a characteristic they share with all humans – sponsors avoid registering the deprivation these people suffer, and the ethical obligation to offer them remedial help.The distinction between vulnerability and susceptibility also marks the difference between being intact but fragile – vulnerable – and being injured and predisposed to compound additional harm – susceptible. Awareness of this difference should give additional force to the rejection of double standards in research ethics. (shrink)

In discussing methodological and ethical codes for working with children there is a danger that young people can become homogenised as a social category. In this paper we examine the way in which common methodological and ethical dilemmas, such as accessing potential interviewees or gaining consent, can become more complex and significant when the research involves work with a 'vulnerable' group of children or youth. Here, we draw on our own experience of working with self-identified lesbian and gay (...) young people, to demonstrate that research with sexual minorities is particularly sensitive because of the specific laws which frame (or until recently have framed) homosexuality and because of the way in which children are popularly constructed as asexual or innocent. In doing so we also highlight the importance of finding a safe space where interviews can be conducted in privacy and confidence. (shrink)

Objective: There is a demonstrated link between the mental health and substance use comorbidities experienced by young adults, however the vast majority of psychological interventions are disorder specific. Novel psychological approaches that adequately acknowledge the psychosocial complexity and transdiagnostic needs of vulnerable young people are urgently needed. A modular skills-based program for emotion regulation and impulse control addresses this gap. The current one armed open trial was designed to evaluate the impact that 12 weeks exposure to ERIC alongside (...) usual care had on young people's ability to regulate emotions, as well as examine potential moderating mechanisms.Methods: Seventy nine young people were enrolled to the 12 week intervention period. Twenty one practitioners from youth and community health services delivered relevant ERIC modules adjunct to usual care. Linear mixed effects regression was used to examine change over time across the primary outcome of emotion dysregulation and secondary outcomes of depression, anxiety, stress, experiential avoidance and mindfulness. Moderation analyses were conducted to test whether the magnitude of change in emotion dysregulation moderated change over time in secondary outcomes.Results: Analyses revealed significant improvement in the primary outcome of emotion dysregulation with a moderate effect size, in addition to decreases in the secondary outcomes of depression, anxiety, stress and experiential avoidance. No improvements in mindfulness were reported. Moderation analyses revealed that the residualised change over time in emotion dysregulation moderated the change over time in symptoms of distress, depression, anxiety, stress, experiential avoidance, and mindfulness.Conclusion: Reductions in the severity of emotion dysregulation, depression, anxiety, stress and experiential avoidance are promising, and were evident despite the complexity of the participants and the diversity of the service setting. The improvements found in each outcome were only observed for those young people whose emotion regulation also improved, providing preliminary evidence for the role of emotion regulation as a key treatment target in this population. (shrink)

Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. Some plans that concern rationing during a severe pandemic recommend ways to protect socially vulnerable (...) groups without prioritizing access to scarce resources based on social vulnerability per se. The Minnesota Pandemic Ethics Project (MPEP), a public engagement project on rationing scarce health resources during a severe influenza pandemic, agrees and recommends an integrated set of ways to attend to the needs of socially vulnerable people and avoid exacerbation of health disparities during a severe influenza pandemic. Among other things, MPEP recommends: 1. Engaging socially vulnerable populations to clarify unique needs and effective strategies; 2. Engaging socially vulnerable populations to elicit ethical values and perspectives on rationing; 3. Rejecting rationing based on race, socioeconomic class, citizenship, quality of life, length of life-extension and first-come, first-served; 4. Prioritizing those in the general population for access to resources based on combinations of risk (of death or severe complications from influenza, exposure to influenza, transmitting influenza to vulnerable groups) and the likelihood of responding well to the resource in question. 5. Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and serious morbidity and to optimize the distribution of resources. (shrink)

(Conference proceedings 2014) This presentation (International Development Ethics Association, July 2014) considers economic vulnerability, exploring the risk of deprivation of necessary resources due to a complex and rarely discussed vulnerability that arises from hope. Pierre Bourdieu’s sociological account of French petit-bourgeois aspiration in The Social Structures of the Economy has recently inspired Wendy Olsen to introduce the term “aspiration paradox” to characterize cases wherein “a borrower's status aspirations may contribute to a situation in which their borrowings exceed their capacity to (...) repay,” leaving the individual much the worse, due to an aspiration to betterment. If such financial opportunities were not made available to these people – if some were denied loans due to a careful assessment of their vulnerability – would they be better off? We should seriously consider that they might be. I will hazard the straightforwardly paternalistic suggestion that limiting access to lending to those who are vulnerable to their aspirations can be a just policy. Because aspiration paradox is a cross-cultural phenomenon, and because lending frequently involves asymmetries in mathematical education between borrowers and lenders, I hope to elude at least some of the charges of colonialism that have gained a stronger purchase on adaptive preference arguments. (shrink)

Scientific and technological progress might change people’s capabilities or incentives in ways that would destabilize civilization. For example, advances in DIY biohacking tools might make it easy for anybody with basic training in biology to kill millions; novel military technologies could trigger arms races in which whoever strikes first has a decisive advantage; or some economically advantageous process may be invented that produces disastrous negative global externalities that are hard to regulate. This paper introduces the concept of a (...) class='Hi'>vulnerable world: roughly, one in which there is some level of technological development at which civilization almost certainly gets devastated by default, i.e. unless it has exited the “semi-anarchic default condition”. Several counterfactual historical and speculative future vulnerabilities are analyzed and arranged into a typology. A general ability to stabilize a vulnerable world would require greatly amplified capacities for preventive policing and global governance. The vulnerable world hypothesis thus offers a new perspective from which to evaluate the risk-benefit balance of developments towards ubiquitous surveillance or a unipolar world order. (shrink)

Mainstream academic debate on the ethics of human gene editing is currently not as inclusive as it should be. For example, it currently does not give due consideration to Indigenous groups and cultures, such as those living in rural and remote areas of Canada. Once such people are given due consideration, then several important points emerge, which have so far gone unnoticed or under‐emphasized in the debate. This article focuses on two of those points: (a) Some vulnerable (...) class='Hi'>people who are currently being ignored in the debate may not desire to use gene editing, even if it is safe, effective and affordable, and they will have compelling reasons for making this decision; and (b) even if such people do decide to use the technology, the gene editing enterprise itself is unlikely to do much good for them (and may even be harmful to them), as it alarmingly misses the point regarding the underlying contributing causes of the most pressing problems that those people are facing. Therefore, the promise of the gene editing enterprise is a hollow one for some groups of vulnerable people. These considerations should be used more prominently to guide debate on the ethics of human gene editing. (shrink)

Critics allege that justice as mutual advantage excludes vulnerable people and is thus inadequate as a conception of justice. Building on Peter Vanderschraaf’s Strategic Justice, this paper considers three distinct vulnerability objections. After Sect. 1 clarifies the “vulnerable,” Sect. 2 discusses an objection according to which it is impossible for a mutual advantage view to protect the vulnerable. Answering this objection only requires a possibility proof, such as that Vanderschraaf provides. Section 3 discusses an objection according (...) to which it is merely contingent whether, not guaranteed that, a mutual advantage view protects the vulnerable. Mutual advantage theorists indeed cannot provide such guarantees, so they must argue that such guarantees are too much to demand from a conception of justice. Section 4 discusses an objection according to which it is improbable that a mutual advantage view will protect the vulnerable. Addressing this concern opens paths for future fruitful research, including considering the conditions that make including the vulnerable more or less likely as well as the conditions that facilitate cooperative ability or create vulnerability. Section 5 builds on the foregoing by emphasizing the diversity of vulnerabilities along with the broader social contract tradition’s diversity of strategies for addressing vulnerability. (shrink)

Vulnerability in research is often understood as a diminished ability to protect one's own interests, manifested by a compromised capacity to give informed or voluntary consent. Certain groups of people are thought to be more vulnerable than others and therefore are at risk of being exploited or mistreated in research. Accordingly, the federal regulations call for additional safeguards to protect vulnerable groups.There remains some ambiguity and contradiction, however, regarding what groups are vulnerable in research and why,3 (...) since the available codes of research ethics and regulations describe many groups as vulnerable. When so many groups are considered vulnerable, but no specification is offered as to how they are vulnerable or what particular protections are appropriate, the possibility of meaningful safeguards is diminished. In addition, current concepts of vulnerability are usually applied to whole groups of people, without distinguishing between individuals in a group who might truly have a compromised capacity to protect their own interests from those who do not. (shrink)

This paper shows the state of the art regarding the possibilities of intervention for the economic and social inclusion of young people Not engaged in Employment, Education, or Training through Massive Open Online Courses in the countries of the European Union, in order to identify and compare good practices and didactic models aimed to contrast the social and economic vulnerabilities of young people. The systematic review, carried out on both generalist and more properly educational databases, has revealed the (...) poor relationship between the two topics in literature, each one moreover only recently made the subject of articulated research. The field of study is therefore open and invites further reflection on its possible developments. Matching NEETs’ needs and business companies’ requirements, students’ motivation during the learning path, keeping balance between e-learning and face-to-face lectures, tutors’ involvement along the course, and relationships with stakeholders remain the main issues identified in the various papers reviewed. (shrink)

Implanted medical devices—for example, cardiac defibrillators, deep brain stimulators, and insulin pumps—offer users the possibility of regaining some control over an increasingly unruly body, the opportunity to become part “cyborg” in service of addressing pressing health needs. We recognize the value and effectiveness of such devices, but call attention to what may be less clear to potential users—that their vulnerabilities may not entirely disappear but instead shift. We explore the kinds of shifting vulnerabilities experienced by people with Parkinson’s disease (...) (PD) who receive therapeutic deep brain stimulators to help control their tremors and other symptoms of PD. (shrink)

All people are vulnerable to having their self-concepts shaped by others. This article investigates that vulnerability using a theory of narrative self-constitution. According to narrative self-constitution, people depend on others to develop and maintain skills of self-narration and they are vulnerable to having the content of their self-narratives co-authored by others. This theoretical framework highlights how vulnerability to co-authoring is essential to developing a self-narrative and, thus, the possibility of autonomy. However, this vulnerability equally entails that (...) co-authors can undermine autonomy by contributing disvalued content to the agent’s self-narrative and undermining her authorial skills. I illustrate these processes with the first-hand reports of several women who survived sexual abuse as children. Their narratives of survival and healing reveal the challenges involved in developing the skills required to manage vulnerability to co-authoring and how others can help in this process. Finally, I discuss some of the implications of co-authoring for the healthcare professional and the therapeutic relationship. (shrink)

This paper explores the critical roles of researchers in research involving vulnerable populations. Its purpose is to reflect on the complex nature of vulnerability of Bhutanese refugee women who had resettled in Australia involved in research looking at the barriers to accessing preventive cancer screening. First, we describe the vulnerabilities considered prior to the research study and the actions taken to protect participants while the study was conducted. Second, we discuss those vulnerabilities that we did not anticipate, but were (...) subsequently revealed during the study and consequently included in the study findings. These vulnerabilities should be considered for future research involving similar populations. It is important for researchers to use appropriate research designs that enable the voice of vulnerable people to be heard and to use research strategies that ensure findings are robust and participants are protected and empowered. Potential implications include the development of research practices that take account of the sources of vulnerabilities and consideration of how different vulnerabilities can evolve and affect findings and research recommendations. (shrink)

The concept of vulnerability has become widely acknowledged as a fundamental concept for medical ethics and research ethics, yet rarely considered with respect to ethical assessments of human germline genome editing. A first aim of this paper is to make vulnerability ethics considerations fruitful for issues related to these technical innovations. The possibility of altering the genome promises to overcome forms of vulnerability inherently connected to our existence as physical beings and would hence allow to increase the resilience of human (...) nature or even to move evolution forward by equipping people with new character traits and enhanced capabilities. I suggest a more fine-grained distinction of various applications purposes than the dichotomy of therapeutic and enhancement. I support the rejection of most application purposes as ‘therapeutic’ and claim that framing them as ‘therapeutic’ in the context of the current discursive constellation runs the risk of accentuating existing vulnerabilities. With respect to intergenerational responsibilities, I reject the view that editing the germline necessarily leads to corrupt intergenerational relations based on which it must be categorically excluded. I conclude that it is nevertheless important to take a very close look at the challenges that arise, especially from a vulnerability perspective, before irreversible facts are created overhastily. (shrink)