Respect for Human Vulnerability: The Emergence of a New Principle in Bioethics
Vulnerability has become a popular though controversial topic in bioethics, notably since 2000. As a result, a common body of knowledge has emerged (1) distinguishing between different types of vulnerability, (2) criticizing the categorization of populations as vulnerable, and (3) questioning the practical implications. It is argued that two perspectives on vulnerability, i.e., the philosophical and political, pose challenges to contemporary bioethics discourse: they re-examine the significance of human agency, the primacy of the individual person, and the negativity of vulnerability. As a phenomenon of globalization, vulnerability can only be properly addressed in a global bioethics that takes the social dimension of human existence seriously.
KeywordsGlobal bioethics Globalization Vulnerability Research ethics Philosophy of medicine
- Anonymous. 1980. The hospital industry’s new vulnerability to antitrust. Regulation 4(5): 12–13.Google Scholar
- Beauchamp, T., and J. Childress. 2012. Principles of biomedical ethics, 7th ed. New York and Oxford: Oxford University Press.Google Scholar
- Belmont Report. 1979. Ethical principles and guidelines for the protection of human subjects of research, Report of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. Federal Register 44(76): 23191–23197.Google Scholar
- Benaroyo, L. 2007. The notion of vulnerability in the philosophy of Emmanuel Levinas and its significance for medical ethics and aesthetics. http://www.api.or.at/aebm/download/docs/web_levinas.pdf.
- Botbol-Baum, M. 2000. The necessary articulation of autonomy and vulnerability. In Basic ethical principles in European bioethics and biolaw: Vol. II: Partners’ research, edited by J. D. Rendtorff, and P. Kemp, 57–64. Copenhagen and Barcelona: Centre for Ethics and Law and Institut Borja de Bioetica.Google Scholar
- Callahan, D. 2000. The vulnerability of the human condition. In Bioethics and biolaw: Vol. II: Four ethical principles, edited by P. Kemp, J. Rendtorff, and N. Mattson Johansen, 115–122. Copenhagen: Rhodos International Science and Art Publishers & Centre for Ethics and Law.Google Scholar
- CIOMS. 1982. Proposed international guidelines for biomedical research involving human subjects. In Bioethics: Issues and perspectives, edited by S. Scholle Connor, and H.L. Fuenzalida-Puelma, 220–226. Washington, DC: Pan American Health Organization.Google Scholar
- CIOMS. 1991. International guidelines for ethical review of epidemiological studies. http://www.cioms.ch/publications/guidelines/1991_texts_of_guidelines.htm. Accessed September 14, 2012.
- CIOMS. 1993. International ethical guidelines for biomedical research involving human subjects. http://www.codex.uu.se/texts/international.html. Accessed September 14, 2012.
- CIOMS. 2002. International ethical guidelines for biomedical research involving human subjects. http://www.cioms.ch/publications/guidelines/guidelines_nov_2002_blurb.htm. Accessed September 14, 2012.
- Danis, M., and D. Patrick. 2002. Health policy, vulnerability, and vulnerable populations. In Ethical dimensions of health policy, edited by M. Danis, C. Clancy, and L. Churchill, 310–334. New York: Oxford University Press.Google Scholar
- DeBruin, D. 2001. Reflections on “vulnerability.” Bioethics Examiner 5(2): 1, 4, 7.Google Scholar
- Delor, F., and M. Hubert. 2000. Revisiting the concept of “vulnerability.” Social Science & Medicine 50(11): 1557–1570.Google Scholar
- Eckenwiler, L., C. Ellis, D. Feinholz, and T. Schonfeld. 2008. Hopes for Helsinki: Reconsidering “vulnerability.” Journal of Medical Ethics 34(10): 765–766.Google Scholar
- Flanigan, R. 2000. Vulnerability and the bioethics movement. Bioethics Forum 16(2): 13–18.Google Scholar
- Gehlen, A. 1988. Man: His nature and place in the world. New York: Columbia University Press. Originally published as Der Mensch, seine Natur und seine Stellung in der Welt (Berlin: Junker und Dünnhaupt, 1940).Google Scholar
- Goodin, R.E. 1985. Protecting the vulnerable: A reanalysis of our social responsibilities. Chicago and London: The University of Chicago Press.Google Scholar
- IBC (International Bioethics Committee). 2011. Report of the IBC on the principle of respect for human vulnerability and personal integrity. Paris: UNESCO, SHS/EST/CIB-17/10/CONF.501/2 Rev 2. http://unesdoc.unesco.org/images/0018/001895/189591e.pdf.
- Kahn, K., and J.H. Bryant. 1994. The vulnerable in developed and developing countries—a conceptual approach. In Poverty, vulnerability, the value of human life, and the emergence of bioethics, edited by Z. Bankowski, and J.H. Bryant, 57–63. Geneva: CIOMS.Google Scholar
- Kipnis, K. 2001. Vulnerability in research subjects: A bioethical taxonomy. In Ethical and policy issues in research involving human research participants, edited by the National Bioethics Advisory Commission, G1–G13. Bethesda, MD: National Bioethics Advisory Commission.Google Scholar
- Kipnis, K. 2004. The limitations of “limitations.” The American Journal of Bioethics 4(3): 70–72.Google Scholar
- Kirby, P. 2006. Vulnerability and violence: The impact of globalisation. London and Ann Arbor, MI: Pluto Press.Google Scholar
- Kirby, P. 2010. Vulnerability and globalization: The social impact of vulnerability. In Handbook of globalization studies, edited by B. Turner, 113–134. London: Routledge.Google Scholar
- Levinas, E. 2009. Otherwise than being or beyond essence. Pittsburgh, PA: Duquesne University Press. Originally published as Autrement qu’ȇtre ou Au-delà de l’essence (La Haye: Martinus Nijhoff, 1974).Google Scholar
- Levine, R.J. 1981. Ethics and regulation of clinical research. Baltimore and Munich: Urban & Schwarzenberg.Google Scholar
- Levine, R.J., and K. Lebacqz. 1979. Some ethical considerations in clinical trials. Clinical Pharmacology and Therapeutics 25(5/2): 728–741.Google Scholar
- Luna, F. 2006. Bioethics and vulnerability: A Latin American view. Amsterdam and New York: Rodopi.Google Scholar
- Mackenzie, C., W. Rogers, and S. Dodds, eds. 2014. Vulnerability: New essays in ethics and feminist philosophy. Oxford and New York: Oxford University Press.Google Scholar
- Morawa, A. 2003. Vulnerability as a concept in international human rights law. Journal of International Relations and Development 6(2): 139–155.Google Scholar
- Morin, E. 2005. Introduction à la pensée complexe. Paris: Points.Google Scholar
- National Bioethics Advisory Commission (NBAC). 2001. Ethical and policy issues in research involving human participants: Vol. 1: Reports and recommendations of the National Bioethics Advisory Commission. Bethesda, MD: National Bioethics Advisory Commission.Google Scholar
- Patrão Neves, M. 2009. Article 8: Respect for human vulnerability and personal integrity. In The UNESCO Universal Declaration on Bioethics and Human Rights: Background, principles and application, edited by H. ten Have and M.S. Jean, 155–164. Paris: UNESCO Publishing.Google Scholar
- Pellegrino, E.D., and D.C. Thomasma. 1981. A philosophical basis of medical practice: Toward a philosophy and ethic of the healing professions. New York and Oxford: Oxford University Press.Google Scholar
- Reich, W. 2005. The power of a single idea. In Bioetica ou bioeticas na evolução das sociedades, edited by M. Patrão Neves and M. Lima, 380–382. Coimbra: Grafica de Coimbra.Google Scholar
- Ricoeur, P. 2007. Reflections on the just. Chicago and London: University of Chicago Press. Originally published as Le juste, I (Paris: Esprit, 2001).Google Scholar
- Scholte, J.A. 2000. Globalization: A critical introduction. Basingstoke: Palgrave.Google Scholar
- ten Have, H. 2014. The principle of vulnerability in the UNESCO Declaration on Bioethics and Human Rights. In The principle of human vulnerability in bioethics: Religious perspectives, edited by J. Tham, G. Miranda, and A. Garcia, 15–28. Dordrecht: Springer.Google Scholar
- Thomasma, D.C. 2000. The vulnerability of the sick. Bioethics Forum 16(2): 5–12.Google Scholar
- United Nations. 2003. Report on the world social situation: Social vulnerability: Sources and challenges. New York: United Nations Department of Economic and Social Affairs.Google Scholar
- United Nations Development Program (UNDP). 1999. Human development report 1999. New York: Oxford University Press.Google Scholar
- United Nations Educational, Scientific and Cultural Organization (UNESCO). 2005. Universal declaration on bioethics and human rights. http://unesdoc.unesco.org/images/0014/001461/146180e.pdf. Accessed September 14, 2012.
- WMA (World Medical Association). 2000. Declaration of Helsinki, 5th revision. http://ohsr.od.nih.gov/guidelines/helsinki.html. Accessed September 14, 2012.
- WMA (World Medical Association). 2008. Declaration of Helsinki, 6th revision. http://www.wma.net/en/30publications/10policies/b3/index.html.pdf?print-media-type&footer-right=[page]/[toPage]. Accessed September 14, 2012.