Advertisement

Vulnerability in Old Age. The Fragility of Inappropriately Protected Interests

  • Samia HurstEmail author
Chapter
Part of the International Perspectives on Aging book series (Int. Perspect. Aging, volume 25)

Abstract

Protecting the vulnerable is recognized as important; but who is vulnerable and what protections are needed? Six definitions of vulnerability are found in the literature: human finitude, an incapacity to defend one’s own interests, fragility, barriers to health, list-based definitions, and layered vulnerability. Because none of these definitions adequately captures cases where particular vulnerability might exist, we proposed to define vulnerability as an increased risk of being wronged or having our morally protected interests unjustly considered. In applying this definition to old age, many forms of vulnerability both within medicine and in everyday life are revealed. These vulnerabilities can form clusters: Ordinary protections and practices are developed for the situations that, for various reasons, are considered to be the most important or the most “normal” in a given society. Rather than being a misfortune that we may have some duty to compensate, such situations represent a direct consequence of our collective actions: We are committing wrongs and have a much stronger duty to correct this.

References

  1. Bozzaro, C., Boldt, J., & Schweda, M. (2018). Are older people a vulnerable group? Philosophical and bioethical perspectives on ageing and vulnerability. Bioethics, 32(4), 233–239.CrossRefGoogle Scholar
  2. Breeze, E., Fletcher, A. E., Leon, D. A., Marmot, M. G., Clarke, R. J., & Shipley, M. J. (2001). Do socioeconomic disadvantages persist into old age? Self-reported morbidity in a 29-year follow-up of the Whitehall Study. American Journal of Public Health, 91(2), 277–283.CrossRefGoogle Scholar
  3. Brock, D. W. (2002). Health resource allocation for vulnerable populations. In M. Danis, C. Clancy, & L. R. Churchill (Eds.), Ethical dimensions of health policy (pp. 283–309). Oxford: Oxford University Press.Google Scholar
  4. Callahan, D. (2000). The vulnerability of the human condition. In P. Kemp, J. Rendtorff, & N. M. Johansen (Eds.), Bioethics and biolaw, volume II: Four ethical principles (pp. 115–122). Copenhagen: Rhodos International Science and Art Publishers and Centre for Ethics and Law in Nature and Society.Google Scholar
  5. Daniels, N. (1985). Just health care. Cambridge/New York: Cambridge University Press.Google Scholar
  6. Danis, M., & Patrick, D. L. (2002). Health policy, vulnerability, and vulnerable populations. In M. Danis, C. Clancy, & L. R. Churchill (Eds.), Ethical dimensions of health policy (pp. 310–336). Oxford/New York: Oxford University Press.Google Scholar
  7. Holm, S. (2013). The implicit anthropology of bioethics and the problem of the aging person. In M. Schermer & W. Pinxten (Eds.), Ethics, health policy and (anti-)aging: Mixed blessings (pp. 59–71). Dordrecht: Springer.CrossRefGoogle Scholar
  8. Hurst, S. A. (2008). Vulnerability in research and health care: Describing the elephant in the room? Bioethics, 22(4), 191–202.CrossRefGoogle Scholar
  9. Hurst, S. A. (2009). Just care: Should doctors give priority to patients of low socioeconomic status? Journal of Medical Ethics, 35(1), 7–11.CrossRefGoogle Scholar
  10. Hurst, S. A. (2013). Protecting vulnerable persons: An ethical requirement in need of clarification. Revue Médicale Suisse, 9(386), 1054–1057.Google Scholar
  11. Hurst, S. A. (2015). Clarifying vulnerability: The case of children. Asian Bioethics Review, 7(2), 126–138.CrossRefGoogle Scholar
  12. Hurst, S. A. (2016). The most vulnerable patients in healthcare. In C. Straehle (Ed.), Vulnerability, autonomy, and applied ethics (pp. 123–137). New York: Routledge.Google Scholar
  13. Kipnis, K. (2003). Seven vulnerabilities in the pediatric research subject. Theoretical Medicine and Bioethics, 24(2), 107–120.CrossRefGoogle Scholar
  14. Kottow, M. H. (2003). The vulnerable and the susceptible. Bioethics, 17(5–6), 460–471.CrossRefGoogle Scholar
  15. Lindemann, H. (2014). Holding and letting go: The social practice of personal identity. Oxford/New York: Oxford University Press.CrossRefGoogle Scholar
  16. Lott, J. P. (2005). Module three: Vulnerable/special participant populations. Developing World Bioethics, 5(1), 30–54.CrossRefGoogle Scholar
  17. Luna, F. (2009). Elucidating the concept of vulnerability: Layers not labels. International Journal of Feminist Approaches to Bioethics, 2(1), 121–139.CrossRefGoogle Scholar
  18. Luna, F. (2018). Identifying and evaluating layers of vulnerability: A way forward. Developing World Bioethics, 19, 86–95.CrossRefGoogle Scholar
  19. MacIntyre, A. (1999). Dependent rational animals. Chicago/La Salle: Open Court.Google Scholar
  20. Martin, A. K., Tavaglione, N., & Hurst, S. A. (2014). Resolving the conflict: Clarifying ‘vulnerability’ in health care ethics. Kennedy Institute of Ethics Journal, 24(1), 51–72.CrossRefGoogle Scholar
  21. Nussbaum, M. (2003). Capabilities as fundamental entitlements: Sen and social justice. Feminist Economics, 9(2–3), 33–59.CrossRefGoogle Scholar
  22. Rendtorff, J. D. (2002). Basic ethical principles in European bioethics and biolaw: Autonomy, dignity, integrity and vulnerability – Towards a foundation of bioethics and biolaw. Medicine, Health Care & Philosophy, 5(3), 235–244.CrossRefGoogle Scholar
  23. Riedl, M., Mantovan, F., & Them, C. (2013). Being a nursing home resident: A challenge to one’s identity. Nursing Research and Practice, 2013, article ID 932381, 1–9.Google Scholar
  24. Robeyns, I. (2016). Conceptualising well-being for autistic persons. Journal of Medical Ethics, 42, 383–390.CrossRefGoogle Scholar
  25. Rodogno, R. (2015). Well-being, science and philosophy. In J. H. Søraker, J.-W. van der Rijt, J. Jelle de Boer, P.-H. Wong, & P. Brey (Eds.), Well-being in contemporary society (pp. 39–57). Berlin: Springer.Google Scholar
  26. Tavaglione, N., Martin, A. K., Mezger, N., Durieux-Paillard, S., Francois, A., Jackson, Y., & Hurst, S. A. (2015). Fleshing out vulnerability. Bioethics, 29(2), 98–107.CrossRefGoogle Scholar
  27. Wolff, J., & de-Shalit, A. (2007). Disadvantage. Oxford: Oxford University Press.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.University of GenevaGenevaSwitzerland

Personalised recommendations