Abstract
The concept of vulnerability has been hotly debated in research ethics literature. Some critics considered it a useless concept. In 2009—against some of those criticisms—I defended the importance of understanding this concept in terms of layers instead of applying it as a label given to certain subpopulations. In this paper, I present some of the limits of this analysis and I also explore the similarities and differences this approach has when compared to using a taxonomy as another answer on how to assess vulnerability. I present the notion of cascade vulnerability and underscore the dispositional character of layers and their relevance to identify and evaluate layers of vulnerability. Finally, I show how this layered account has been incorporated in important documents such as the new 2016 CIOMS-WHO Guidelines.
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- 1.
There was also a thorough conceptualization of this notion in analytic ethics by Goodin (1985).
- 2.
For further discussion on this notion, see Luna (2009a).
- 3.
- 4.
They criticize the CIOMS Guidelines, Zion et al (2000), Ruth Macklin, and Kenneth Kipnis, among others.
- 5.
For further discussion, see Luna (2009a).
- 6.
This section is based in Luna (2009b). In this article, I use the terms “political-ethical” sphere and “theoretical-ethical” sphere, literally translated. The article was written in Spanish and the denomination in that language fits better than its translation into English. In this article, I am using another translation of the terms but I maintain the same distinction.
- 7.
Although these are two different spheres of discussion, they are closely related. Thus if we cannot offer an adequate answer to the conceptual sphere we will not be able to defend its practical relevance.
- 8.
See Luna (2009a).
- 9.
I accept Kipnis’s account as an open list of categories but not as a fixed taxonomy (see my upcoming article on this issue).
- 10.
For further examples, see Luna (2009a).
- 11.
For example, in Luna (2014), I show the different layers of vulnerability that elderly persons may experience and how these complex situations can be tackled by policy makers.
- 12.
I have elsewhere suggested this as a method to be considered by research ethics committees. See Luna (2009a: 129–131).
- 13.
I left the original footnotes in the text (6 and 7) as they refer to one article of my authorship and the other to Hurst’s (2008) article.
- 14.
Specific details are beyond the scope of this article. See Luna (2015).
- 15.
In Luna (2015), I provide some of the reasons I do not think taxonomies are a good strategy.
- 16.
For example, I explain that the lack of an early diagnosis in the case of rare diseases can be considered a cascade vulnerability as it may impact in reproductive decisions, in future treatments, etc. See Luna (2018).
- 17.
This case was presented in Luna (2018).
- 18.
See Luna (2009a).
- 19.
See CIOMS (2016) regarding pregnant women and research (Guideline 19).
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Luna, F. (2019). Revisiting Vulnerability: Its Development and Impact. In: Rivera-López, E., Hevia, M. (eds) Controversies in Latin American Bioethics. International Library of Ethics, Law, and the New Medicine, vol 79. Springer, Cham. https://doi.org/10.1007/978-3-030-17963-2_5
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