GESTIÓN EN SALUD PÚBLICA: “Vulnerable populations”: a necessary concept in research ethics?

sábado, 2 de septiembre de 2017

“Vulnerable populations”: a necessary concept in research ethics?

“Vulnerable populations”: a necessary concept in research ethics?

by Xavier Symons | 2 Sep 2017 |

How important is the label “vulnerable populations” in research ethics?

“Vulnerable populations” are groups of individuals who in one or more ways are at risk of harm through research; research ethics committees often use the term to identify groups that are at risk in particular research projects.

In recent years scholars have criticised the use of this term, as it lacks a sensitivity to contextual factors that impact on the vulnerability of individuals -- pregnant women, for example, may be more or less vulnerable depending on the stage of gestation or the presence of illness, and minority groups can differ in their susceptibility to exploitation or manipulation.

But some commentators are defending the use of “vulnerability” in research ethics.

National University of Singapore sociologist Adrian Kwek argues that we need the label of vulnerability to reason through difficult ethical problems in bioethics. Writing in the journal Bioethics, Kwek suggests that where principlism and casuistry fail to provide uncontroversial ethical conclusions, reference to vulnerable populations can provide a way of resolving relevant bioethical quandaries: “labelled groups as exemplars of vulnerability can play indispensable roles in bioethical reasoning”. Kwek states:

“The pair of reasoning methods that has received much attention in bioethics – specified principlism and casuistry – can leave gaps that require intuitive balancing. Labelled groups as exemplars of vulnerability can plug some of these gaps. The contribution is both practical in helping to arrive at morally nuanced judgments and theoretical in providing a further provisionally stable point of discursive justification where specified norms conflict or where paradigm cases are underdetermined.”

Duquesne University bioethicist Henk Ten Have gone so far as to argue that vulnerability should be introduced as a new principle in biomedical ethics. In a 2015 article in Bioethical Inquiry, Ten Have argued that bioethics should begin by considering the fact of human vulnerability -- the fragility and weakness characteristic of the human condition -- and develop ethical procedures based on this fundamental observation.

“Fatherhood” is what the guys in the business of policing the language call an “essentially contested concept” – no matter how much palaver you invest in it, you won’t make any progress. At least nowadays.

Below we feature a story from the Netherlands about two men who have each sired over a hundred children, one through sperm donation to IVF clinics, the other mostly through more conventional channels. Are they fathers?

Another story comes from Australia, which is girding its loins for a campaign on same-sex marriage. A group promoting closer links between fathers and their children, Dads4Kids, has been running a public service TV advertisement for 15 years. This year, a 30-second spot of a dad crooning to his wee sprog was rejected because it was “too political”.

A spokesman for the foundation complained:

“It is extraordinary that this is where we have come to as a country; we can no longer celebrate Father’s Day without being forced to look at it through the lens of the same-sex marriage debate. It’s a tragedy that a political motive is now implied in any mention of fatherhood. Not everything is about same-sex marriage.”

The history of this simple advertisement tracks the evolving concept. In a span of 15 years, fatherhood, or rather “fatherhood”, has shifted from a universally admired status to a politically suspect notion. Are we the better for it?

Happy Father’s Day to our Australian readers.