The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
The Limitations of “Vulnerability” as a Protection for Human Research Participants
Abstract
Vulnerability is one of the least examined concepts in research ethics. Vulnerability was linked in the Belmont Report to questions of justice in the selection of subjects. Regulations and policy documents regarding the ethical conduct of research have focused on vulnerability in terms of limitations of the capacity to provide informed consent. Other interpretations of vulnerability have emphasized unequal power relationships between politically and economically disadvantaged groups and investigators or sponsors. So many groups are now considered to be vulnerable in the context of research, particularly international research, that the concept has lost force. In addition, classifying groups as vulnerable not only stereotypes them, but also may not reliably protect many individuals from harm. Certain individuals require ongoing protections of the kind already established in law and regulation, but attention must also be focused on characteristics of the research protocol and environment that present ethical challenges.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Bioethicists are highly critical of the vagueness of the label and its propensity to stereotype groups of quite diverse patients.37”
Citations
Cites
(2001) · Journal of obstetrics and gynaecology research · doi:10.1111/j.1447-0756.2001.tb01222.x · Cited by 3,515
Beecher, H. K. (1966) · New England Journal of Medicine · doi:10.1056/nejm196606162742405 · Cited by 1,961
Protecting the Vulnerable: A Reanalysis of Our Social Responsibilities
Goodin, R. E. (1985) · Cited by 937
Ethics and Regulation of Clinical Research.
(1986) · Annals of Internal Medicine · doi:10.7326/0003-4819-105-6-989_1 · Cited by 865
Bad Blood: The Tuskegee Syphilis Experiment
Kiple, K. F., & Jones, J. H. (1982) · The American Historical Review · doi:10.2307/1870318 · Cited by 817
Strangers at the bedside: a history of how law and bioethics transformed medical decision making
Baker, R. (1991) · Choice Reviews Online · doi:10.5860/choice.29-0348 · Cited by 551
Experimentation with Human Beings
Katz, J. (1972) · Stanford Law Review · doi:10.2307/1227842 · Cited by 483
Bad Blood: The Tuskegee Syphilis Experiment.
Daniel, P., & Jones, J. H. (1982) · The Journal of Southern History · doi:10.2307/2207140 · Cited by 298
Subjected to Science: Human Experimentation in America before the Second World War
Lederer, S. E., & Davis, A. B. (1995) · History Reviews of New Books · doi:10.1080/03612759.1995.9949143 · Cited by 243
Bioethics, Vulnerability, and Protection
Macklin, R. (2003) · Bioethics · doi:10.1111/1467-8519.00362 · Cited by 210
Research works printed but not linked: 7
- 2002, International Ethical Guidelines for Biomedical Research Involving Human Subjects, Commentary on Guideline 13
- DeBruin D., 2001, Bioethics Examiner, 1, 4
- Hawana J. S., 2003, Vulnerable research subjects may exceed definition in clinical research
- Kipnis K., 2001, Ethical and policy issues in research involving human research participants, G-1
- Code of Federal Regulations, Title 45, Part 46, Protection of Human Subjects
- 2001, NIH policy and guidelines on the inclusion of women and minorities as subjects in clinical research—Amended October 2001
- 2001, Institutional Review Board Guidebook
Cited by
Sorted by citations
Items 301–400 of 437
Phelps, J. L. (2020) · IEEE Transactions on Professional Communication · doi:10.1109/tpc.2019.2961011 · Cited by 2
Vulnerability Created by Legal Capacity Denials
Arstein-Kerslake, A. (2021) · Springer eBooks · doi:10.1007/978-3-030-63493-3_5 · Cited by 2
Ethics in Palliative Care Research
Raus, K., & Sterckx, S. (2018) · Springer eBooks · doi:10.1007/978-3-319-31738-0_110-1 · Cited by 2
Vulnerability in palliative care: an application and extension of the risk chain model
Asada, Y. (2010) · Progress in Palliative Care · doi:10.1179/096992610x12624290276665 · Cited by 2
Silaigwana, B. (2017) · ResearchSpace (University of KwaZulu-Natal) · Cited by 2
Synergizing Vulnerability and Cultural Sensitivity in Studying Forced Migrants
Alshoubaki, W. (2024) · Springer eBooks · doi:10.1007/978-3-031-58791-7_4 · Cited by 1
Das Schichtenkonzept kontextabhängiger Vulnerabilität im Gesundheitswesen
Mainka, C. (2024) · Zeitschrift für Ethik und Moralphilosophie · doi:10.1007/s42048-024-00205-1 · Cited by 1
The meaning of ethical collaborative research according to young people
Chrifou, R., Focquaert, F., Messiha, K., Ghaly, M. M., Altenburg, T. M., Deforche, B. I., & Verloigne, M. (2025) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2025.2517099 · Cited by 4
Principles and Practical Guides to Ethics in Dental Research
Baharuddin, N. A., Hussin, M. K., Porasuphatana, S., & Anuwar, A. H. K. (2025) · Springer eBooks · doi:10.1007/978-981-97-0275-6_5-1 · Cited by 1
Digital Criminology, Vulnerability Theories and Digital Vulnerability
McKay, C. (2025) · Springer eBooks · doi:10.1007/978-3-032-10028-3_2 · Cited by 1
The value of vulnerability for trustworthy AI
Talamanca, G. F. (2026) · AI & Society · doi:10.1007/s00146-026-02892-3 · Cited by 1
Vulnerability and Its Theoretical Analysis
Luna, F. (2026) · The International Library of Bioethics · doi:10.1007/978-3-032-14594-9_6 · Cited by 1
Vulnerability as a normative concept: reviving the scepticism
Soofi, H. (2026) · Medicine Health Care and Philosophy · doi:10.1007/s11019-026-10345-3 · Cited by 1
Chiappinotto, S., Moreal, C., Bayram, A., Velikonja, N. K., Özsaban, A., Solà‐Pola, M., Novella, A. R., Zdunek, K., Dobrowolska, B., & Palese, A. (2026) · Journal of Personalized Medicine · doi:10.3390/jpm16060296 · Cited by 1
Groman, M., & Grady, C. (2015) · Asian Bioethics Review · doi:10.1353/asb.2015.0008 · Cited by 1
Self-citationExcluded, not dismissed: Enhancing benefit in clinical research
Nardell, M., Chhabra, A., & Pal, L. (2012) · Contemporary Clinical Trials · doi:10.1016/j.cct.2012.08.013 · Cited by 1
Design and Direction in Research Ethics: A Question of Direction
Clark, C. C. (2004) · The American Journal of Bioethics · doi:10.1080/15265160490497209 · Cited by 1
A Social Work Perspective on Paediatric and Adolescent Research Vulnerability
McGregor, K. A., Hall, J. A., Wilkerson, D., Bennett, L. W., & Ott, M. A. (2016) · Social Work and Social Sciences Review · doi:10.1921/swssr.v18i2.904 · Cited by 1
Busso, C., & Sanz, P. L. (2016) · Persona y Bioética · doi:10.5294/pebi.2016.20.2.2 · Cited by 1
Ethical Issues in Conducting Research on Religion and Spirituality
Loue, S. (2017) · Springer eBooks · doi:10.1007/978-1-4939-7039-1_22 · Cited by 1
Herring, J. (2018) · SpringerBriefs in law · doi:10.1007/978-3-319-78686-5_2 · Cited by 1
Ethical Considerations for Nursing Research With Military Populations
Migliore, L. A., & Killian, J. M. (2018) · Annual Review of Nursing Research · doi:10.1891/0739-6686.36.1.107 · Cited by 1
Vulnerability in Research with Prisoners
Christopher, P. P. (2021) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190947750.013.42 · Cited by 1
Schramme, T., Derpmann, S., Wiesing, U., Schildmann, J., Vollmann, J., Wiesemann, C., Buyx, A., Dufner, A., Spranger, T. M., Gutmann, M., et al. (2015) · J.B. Metzler eBooks · doi:10.1007/978-3-476-05323-7_3 · Cited by 1
Resnik, D. B. (2018) · International library of ethics, law, and the new medicine/The international library of ethics, law, and the new medicine · doi:10.1007/978-3-319-68756-8_9 · Cited by 1
RESEARCH VULNERABILITY: AN ILLUSTRATIVE CASE STUDY FROM THE SOUTH AFRICAN MINING INDUSTRY
Horn, L. M. (2006) · Developing World Bioethics · doi:10.1111/j.1471-8847.2006.00151.x · Cited by 1
Pham, M. T., Sample, M., Dasgupta, I., Goering, S., & Klein, E. P. (2022) · Handbook of Neuroengineering · doi:10.1007/978-981-15-2848-4_110-1 · Cited by 1
Persons and Groups: Protection of Research Participants with Vulnerabilities as a Process
Łuków, P. (2023) · Philosophy and medicine · doi:10.1007/978-3-031-12692-5_4 · Cited by 1
Haavoittuvuuden etiikka hoidossa ja kliinisessä tutkimuksessa
Lindholm, O., Karjalainen, S., & Launis, V. (2023) · Sosiaalilääketieteellinen Aikakauslehti · doi:10.23990/sa.129113 · Cited by 1
El Ejército Nacional de Colombia y la gestión de la logística humanitaria
Sierra-Zamora, P. A., & Aristizábal-Murillo, J. C. (2024) · doi:10.21830/9786289620320 · Cited by 1
Intersecciones de logística humanitaria, ODS y bioética
Silva, J. M. C. (2024) · doi:10.21830/9786289620320.04 · Cited by 1
Gałązka, M. (2022) · PRAWO i WIĘŹ · doi:10.36128/priw.vi41.421 · Cited by 1
Otrishchenko, N., & Wylegała, A. (2025) · Communist and Post-Communist Studies · doi:10.1525/cpcs.2024.2315136 · Cited by 1
Kottow, M. (2011) · SpringerBriefs in public health · doi:10.1007/978-1-4614-2026-2_4 · Cited by 1
de Melo‐Martín, I. (2006) · Bioethics News · doi:10.1007/bf03351453 · Cited by 1
Legal Issues in Social Work Research
Loue, S. (2018) · Springer eBooks · doi:10.1007/978-3-319-77414-5_5 · Cited by 1
Ortúzar, M. G. D. (2018) · doi:10.35537/10915/80766 · Cited by 1
Tackling vulnerability through lifelong learning policies?
Verlage, T., Milenkova, V. G., & Ribeiro, A. B. (2019) · Policy Press eBooks · doi:10.1332/policypress/9781447350361.003.0007 · Cited by 1
Anti-doping research and the Helsinki Declaration: (mis)match?
Sanchini, V., Devriendt, T., & Borry, P. (2020) · Accountability in Research · doi:10.1080/08989621.2020.1733426 · Cited by 1
The plight and vulnerability of children living in South Africa and the calling of the church
Grobbelaar, J. (2020) · African Sun Media eBooks · doi:10.18820/9781928480952/01 · Cited by 1
Reflexionando sobre las medidas coercitivas en salud mental. Análisis bioético y antropológico
Pozón, S. R. (2021) · Cultura de los Cuidados · doi:10.14198/cuid.2021.59.11 · Cited by 2
Sayibu, W. (2014) · Cited by 1
Consent, Assent and Dissent in Dementia Care and Research
O’Neill, D. J. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-416049-1.00008-8 · Cited by 1
Stoia, M., & Oancea, S. (2010) · Romanian Journal of Legal Medicine · doi:10.4323/rjlm.2010.141 · Cited by 1
Govender, S. (2012) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg) · Cited by 1
Anton, B. (2009) · Cambridge Quarterly of Healthcare Ethics · doi:10.1017/s0963180109090252 · Cited by 1
Engagement of high school students with learning disabilities in mathematics learning
Stohl, C. (2016) · Digital Repository Service (Northeastern University) · doi:10.17760/d20209350 · Cited by 2
Tansey, C. M. (2012) · TSpace (University of Toronto) · Cited by 1
Fair Inclusion of Pregnant Women in Clinical Research
van der Zande, I. S. E. (2017) · Utrecht University Repository (Utrecht University) · Cited by 1
Exploring teachers' experiences with grade retention
Thomas, E. J. (2018) · doi:10.17760/d20292232 · Cited by 1
Johnson, J. A. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-373932-2.00031-4 · Cited by 1
Ptsd Symptoms Comparison Emdr and Nfb With Ipv Survivors: Ex- Post-facto StudyPreprint
Shaikh, H. (2023) · Research Square · doi:10.21203/rs.3.rs-3185697/v1 · Cited by 1
INVESTIGATING THE RESEARCHER-PRACTITIONER RELATIONSHIP
Yu, K. (2008) · UpSpace Institutional Repository (University of Pretoria)
A Review of: “Timothy F. Murphy. 2004.Case Studies in Biomedical Research Ethics”
Rodríguez‐Arias, D., & Hervé, C. (2005) · The American Journal of Bioethics · doi:10.1080/15265160590961022
Work-related needs and experiences of people recovering from mental health problems
Cameron, J. (2013) · University of Brighton Repository (University of Brighton)
Malakouti-Nejad, H. (2012) · Scholarship@Western (Western University)
Shifting the Balance: Equalizing Protection for Both Participants and Beneficiaries of Research
Smith, C. (2014) · The American Journal of Bioethics · doi:10.1080/15265161.2014.964875
Kissell, J. L. (2005) · Metamedicine · doi:10.1007/s11017-005-2200-3
DEFINING THE ROLE OF MATURE MINORS IN THE MEDICAL RESEARCH CONSENT PROCESS
French, I. M. A. (2011) · bepress Legal Repository
Klinische Prüfungen mit Arzneimitteln in der Schwangerschaft
Knop, S. (2015) · Göttinger Schriften zum Medizinrecht · doi:10.17875/gup2015-885
PRACTICAL AND ETHICAL PROBLEMS WITH 'VULNERABILITY'
Damelio, J. L. (2011) · D-Scholarship@Pitt (University of Pittsburgh)
McGregor, K. A. (2015) · IUScholarWorks (Indiana University) · doi:10.7912/c2/1196
Equipment use and equipment provision services for people after stroke: A mixed methods study
Boland, P. (2016) · Otago University Research Archive (University of Otago)
Ethical Principles in Clinical Research
Grady, C. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-382167-6.00002-3
Self-citationResnik, D. B., & Mills, M. J. (2017) · John Wiley & Sons, Inc. eBooks · doi:10.1002/9781119023647.ch19
De rol van hulpverleners in het palliatieve zorgonderzoek
van Thiel, G. J. M. W., & Kars, M. C. (2017) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2060-8_19
Research Involving Persons Likely to be Vulnerable
Ali, N. M. (2017) · Research ethics forum · doi:10.1007/978-3-319-65266-5_5
Including Vulnerable Groups in Health Research
Kiyimba, N., Lester, J. N., & O’Reilly, M. J. (2018) · Springer eBooks · doi:10.1007/978-3-319-94839-3_9
The Case for Special Protection for Older People in International Law
Quinn-Butler, R. M. (2018) · Cronfa (Swansea University) · doi:10.23889/suthesis.43238
Consentimiento informado. Fundamentos y problemas de su aplicación práctica
Goyri, V. M. M. B. (2017) · doi:10.22201/iij.9786070295263p.2017
Lee, E. Y. (2017) · Korean Journal of Medical Ethics · doi:10.35301/ksme.2017.20.4.445
“Vulnerability” as a Concept Captive in Its Own Prison
van den Hoonaard, W. C. (2019) · Springer eBooks · doi:10.1007/978-3-319-76040-7_25-1
What vulnerability entails: Sustainability and the limits of political pluralism
Zúñiga, D. (2020) · Constellations · doi:10.1111/1467-8675.12499
Labour rights of the rare diseases population ‒ breaking the glass ceiling
Stojković-Zlatanović, S., Sjeničić, M., & Sovilj, R. P. (2020) · Stanovnistvo · doi:10.2298/stnv200617005s
Vulnerability in Clinical Trials
Yelgar, S. K., Kasarla, L. S., & Mujeebuddin, C. S. (2020) · International Journal of Pharmaceutical Sciences Review and Research · doi:10.47583/ijpsrr.2020.v64i01.001
Zúñiga, D. (2020) · UVic’s Research and Learning Repository (University of Victoria)
An indigenous perspective with regard to the Tsonga children in need of care
Shilenge, M. O. (2020) · Boloka Institutional Repository (North-west University)
Dahane, N., & Godard, B. (2020) · Droit Santé et Société · doi:10.3917/dsso.065.0049
VULNERABILITY DIMENSIONS OF GROUPS OF PERSONS IN ECONOMIC AND SOCIAL CONTEXT. LITERATURE REVIEW
Caragiani, S.-E. (2019) · RePEc: Research Papers in Economics
Mainetti, M. M., & Rocca, S. L. (2020) · Xihmai · doi:10.37646/xihmai.v15i29.329
Ethical Principles and Laws Governing Clinical Research
Karcz, M. (2021) · Springer eBooks · doi:10.1007/978-3-030-68570-6_28
Sumpter, S. (2020) · ResearchWorks at the University of Washington (University of Washington)
Craxì, L. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822569-1.00018-4
Ethische Aspekte in der Verwendung von Augmented Reality in flexiblen Dienstleistungen
Remmers, H. (2021) · Informationsmanagement und digitale Transformation · doi:10.1007/978-3-658-31768-3_12
Osborne, B. S. M., Boniface, E. R., Forbes, M. M., & Jensen, J. T. (2021) · Accountability in Research · doi:10.1080/08989621.2021.1989678
Kottow, M. H. (2016) · Springer eBooks · doi:10.1007/978-3-319-09483-0_439
none (2010) · Progress in Palliative Care · doi:10.1179/096992610x12624290276629
Luna, F. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-409548-9.10478-6
Kottow, M. H. (2015) · Springer eBooks · doi:10.1007/978-3-319-05544-2_439-1
The Vulnerable Groups and Their Legal Value
Macioce, F. (2022) · Critical political theory and radical practice · doi:10.1007/978-3-031-07547-6_3
Lifelong Learning Policies for Young Adults in Europe
(2019) · Policy Press eBooks · doi:10.51952/9781447350668
Issues to Consider as a CCI and Learning Technology Researcher
Giannakos, M. N. (2022) · Springer briefs in educational communications and technology · doi:10.1007/978-3-031-14350-2_10
Ethical and Legal Issues in Veterinary Social Work Research
Loue, S. (2022) · Springer eBooks · doi:10.1007/978-3-031-10330-8_14
Martin, A. K. (2023) · Springer eBooks · doi:10.1007/978-3-031-25078-1_8
Individual Mindset Change and Civil Disobedience in Shaping Societal Re-Evolution
(2023) · Advances in medical education, research, and ethics (AMERE) book series · doi:10.4018/978-1-6684-4808-3.ch009
Metadata
- Authors
- Levine, C., Faden, R., Grady, C., Hammerschmidt, D., Eckenwiler, L., & Sugarman, J.
- Affiliations
- United Hospital Fund (US)
- Johns Hopkins University (US)
- National Institutes of Health (US)
- University of Minnesota (US)
- Old Dominion University (US)
- Venue
- The American Journal of Bioethics
- Publisher
- Informa UK Limited
- Published
- 2004-08
- Volume
- 4
- Issue
- 3
- Pages
- 44-49
- ISSN
- 1526-5161 (ISSN-L)
- 1536-0075
- OpenAlex
- W2085225076
- Cited by
- 438
- References
- 24
- Citations by year
- 2026: 20 · 2025: 18 · 2024: 27 · 2023: 31 · 2022: 33 · 2021: 27 · 2020: 23 · 2019: 23 · 2018: 25 · 2017: 29 · 2016: 19 · 2015: 19 · 2014: 19 · 2013: 12 · 2012: 22
- FWCI
- 12.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Bioethics (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Social Sciences › Sociology and Political Science › Qualitative Research Methods and Ethics
- Keywords
- research participant vulnerability, informed consent, Belmont Report, power imbalance in research, vulnerable populations, international research, stereotypes, research ethics regulation, protection from harm
- MeSH terms
- Child, Choice Behavior, Clinical Trials as Topic, Developing Countries, Humans, Human Experimentation, Informed Consent, Prisoners, Research Design, Socioeconomic Factors, United States, Mental Competency, Patient Selection, Developed Countries, Ethics, Clinical, Ethics Committees, Research, Codes of Ethics, Comprehension, Ethics, Research, Research Subjects, Vulnerable Populations
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review