Theoretical Medicine and Bioethics

, Volume 24, Issue 2, pp 107–120

Seven Vulnerabilities in the Pediatric Research Subject

  • Kenneth Kipnis


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.

children decisional capacity ethics parents pediatrics research vulnerability 


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Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Kenneth Kipnis
    • 1
  1. 1.Department of PhilosophyUniversity of Hawaii at ManoaHonoluluUSA

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