Identifying and evaluating layers of vulnerability - a way forward

Dev World Bioeth. 2019 Jun;19(2):86-95. doi: 10.1111/dewb.12206. Epub 2018 Jul 30.


"Vulnerability" is a key concept for research ethics and public health ethics. This term can be discussed from either a conceptual or a practical perspective. I previously proposed the metaphor of layers to understand how this concept functions from the conceptual perspective in human research. In this paper I will clarify how my analysis includes other definitions of vulnerability. Then, I will take the practical-ethical perspective, rejecting the usefulness of taxonomies to analyze vulnerabilities. My proposal specifies two steps and provides a procedural guide to help rank layers. I introduce the notion of cascade vulnerability and outline the dispositional nature of layers of vulnerability to underscore the importance of identifying their stimulus condition. In addition, I identify three kinds of obligations and some strategies to implement them. This strategy outlines the normative force of harmful layers of vulnerability. It offers concrete guidance. It contributes substantial content to the practical sphere but it does not simplify or idealize research subjects, research context or public health challenges.

Keywords: cascade vulnerability; layers of vulnerability; public health ethics; research ethics; research ethics committees; vulnerability.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomedical Research / ethics*
  • Ethics Committees, Research
  • Ethics, Research
  • Humans
  • Informed Consent / ethics*
  • Moral Obligations
  • Public Health / ethics*
  • Research Subjects*
  • Vulnerable Populations*