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.
“脆弱性”是研究伦理和公共卫生伦理的一个关键概念。这个术语可以从概念或实践的角度来讨论。我之前提出了层次的隐喻，以从概念的角度理解这个概念在人类研究中的作用。在本文中，我将澄清我的分析如何包括其他脆弱性的定义。然后，我将从实践伦理的角度出发，拒绝使用分类法来分析脆弱性。我的建议规定了两个步骤，并提供了一个程序指南，以帮助对层次进行排序。我引入了级联脆弱性的概念，并概述了脆弱性层次的属性，以强调识别其刺激条件的重要性。此外，我确定了三种义务和一些实施它们的策略。这种策略概述了有害脆弱性层次的规范力量。它提供了具体的指导。它为实践领域做出了实质性的贡献，但它并没有简化或理想化研究对象、研究背景或公共卫生挑战。
