Theoretical Medicine and Bioethics

, Volume 24, Issue 2, pp 107–120

Seven Vulnerabilities in the Pediatric Research Subject

Authors

  • Kenneth Kipnis
    • Department of PhilosophyUniversity of Hawaii at Manoa
Article

DOI: 10.1023/A:1024646912928

Cite this article as:
Kipnis, K. Theor Med Bioeth (2003) 24: 107. doi:10.1023/A:1024646912928

Abstract

Most recent thinking about thevulnerability of research subjects uses a``subpopulation'' focus. So conceived, theproblem is to work out special standards forprisoners, pregnant women, the mentally ill,children, and similar groups. In contrast, an``analytical'' approach would identifycharacteristics that are criteria forvulnerability. Using these criteria, one couldsupport a judgment that certain individuals arevulnerable and identify needed accommodationsif they are to serve as research subjects.Seven such characteristics can be evident inchildren: they commonly lack the capacity tomake mature decisions; they are subject to theauthority of others; they (and their parents)may be deferential in ways that can maskunderlying dissent; their rights and interestsmay be socially undervalued; they may haveacute medical conditions requiring immediatedecisions not consistent with informed consent;they may have serious medical conditions thatcannot be effectively treated; and they (andtheir parents) may lack important sociallydistributed goods. Each of thesevulnerabilities can call for special care inthe design and implementation of researchprotocols.

childrendecisional capacityethicsparentspediatricsresearchvulnerability
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© Kluwer Academic Publishers 2003