Vulnerability in Health Care: A Concept Analysis

Abstract

This article introduces the concept of vulnerability in health care and explores the extant literature to determine its tenets. The debate over what constitutes ethical research is centered in part on the concept of vulnerability. The Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978), the first human research ethics guideline to identify vulnerable groups, specified that those identified as vulnerable need extra protections during research participation. Identified limitations of the Belmont Report, especially with regard to racial minorities, led to the Heckler Report (Heckler, M. M., & U. S. Department of Health and Human Services, 1985), which laid the foundation for actionable steps to eliminate health disparities among racial and ethnic minority groups. The American Nurses Association's Code of Ethics for Nurses with Interpretive Statements (American Nurses Association, 2015), requires nurses to promote, advocate, and strive to protect the health, safety, and rights of all individuals and groups. A conceptual understanding of vulnerability allows nurses and researchers to advocate for and better serve individuals and groups deemed vulnerable. Nurse advocacy is paramount in reducing health disparities and improving health outcomes among vulnerable groups.

Keywords: exposure to risk; health disparity; nurse advocacy; powerlessness; social determinants of health; vulnerability.