Why Marginalization, Not Vulnerability, Can Best Identify People in Need of Special Medical and Nutrition Care

AMA J Ethics. 2018 Oct 1;20(10):E941-947. doi: 10.1001/amajethics.2018.941.


In a 2015 paper published in the Journal of Bioethical Inquiry, bioethicist Henk ten Have identifies vulnerability as a "controversial topic in bioethics" and argues that bioethical attention to vulnerability comes at the expense of sufficient attention to the social structures that shape human life. In this paper, we situate ten Have's argument within the broader bioethical literature, emphasizing how critiques of vulnerability can enrich approaches in clinical settings, including in nutrition, where the concept of vulnerability is not foreign (eg, children are often labeled members of a vulnerable group). We use an example of food (in)security to show how reframing vulnerability to capture "layers of marginalization" can help clinicians and organizations more clearly identify who is most in need, develop solutions for what should be done, and determine how and by whom those solutions should be implemented.

Publication types

  • Comment

MeSH terms

  • Bioethics*
  • Child
  • Ethicists
  • Humans
  • Research
  • Respect*