Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comment
. 2018 Oct 1;20(10):E941-947.
doi: 10.1001/amajethics.2018.941.

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

Alexis K Walker  1 , Elizabeth L Fox  1
Affiliations
Comment

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

Alexis K Walker et al. AMA J Ethics. .

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosure

The author(s) had no conflicts of interest to disclose.

Comment on

References

    1. ten Have H Respect for human vulnerability: the emergence of a new principle in bioethics. J Bioeth Inq 2015;12(3):395–408. - PubMed
    1. Luna F Elucidating the concept of vulnerability: layers not labels. Int J Fem Approaches Bioeth 2009;2(1):121–139.
    1. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, US Department of Health, Education and Welfare. The Belmont Report: ethical principles and guidelines for the protection of human subjects of research. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/read-the-... Published April 1979. Accessed February 11, 2018. - PubMed
    1. Protection of Human Subjects, 45 CFR pt 46 (2018).
    1. President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Focusing on vulnerable populations. http://govinfo.library.unt.edu/hcqualitv/meetings/mar12/papch08.htm Published March 1998: chap 8 Accessed February 11, 2018.