The DOI matches its Crossref record; 35 of the 36 references it cites were found in a registry or an index.
The concept of ‘vulnerability’ in research ethics: an in-depth analysis of policies and guidelines
Open accessAbstract
BACKGROUND: The concept of vulnerability has held a central place in research ethics guidance since its introduction in the United States Belmont Report in 1979. It signals mindfulness for researchers and research ethics boards to the possibility that some participants may be at higher risk of harm or wrong. Despite its important intended purpose and widespread use, there is considerable disagreement in the scholarly literature about the meaning and delineation of vulnerability, stemming from a perceived lack of guidance within research ethics standards. The aim of this study was to assess the concept of vulnerability as it is employed in major national and international research ethics policies and guidelines. METHODS: We conducted an in-depth analysis of 11 (five national and six international) research ethics policies and guidelines, exploring their discussions of the definition, application, normative justification and implications of vulnerability. RESULTS: Few policies and guidelines explicitly defined vulnerability, instead relying on implicit assumptions and the delineation of vulnerable groups and sources of vulnerability. On the whole, we found considerable richness in the content on vulnerability across policies, but note that this relies heavily on the structure imposed on the data through our analysis. CONCLUSIONS: Our results underscore a need for policymakers to revisit the guidance on vulnerability in research ethics, and we propose that a process of stakeholder engagement would well-support this effort.
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“This is why our study took utmost care to follow the best ethical practices for conducting sensitive research with vulnerable populations [30].”
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Cook, R. J., Dickens, B. M., & Fathalla, M. F. (2003) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199241323.003.0025 · Cited by 10,825
Eckstein, S. (2003) · Cambridge University Press eBooks · doi:10.1017/cbo9780511550089.028 · Cited by 3,514
Vulnerability: new essays in ethics and feminist philosophy
(2014) · Choice Reviews Online · doi:10.5860/choice.185679 · Cited by 791
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(2002) · PubMed · Cited by 645
Council for International Organizations of Medical Sciences (CIOMS)
(2025) · WORLD SCIENTIFIC eBooks · doi:10.1142/9789811297724_0006 · Cited by 543
Elucidating the concept of vulnerability: Layers not labels
Luna, F. (2009) · International Journal of Feminist Approaches to Bioethics · doi:10.3138/ijfab.2.1.121 · Cited by 477
Universal Declaration on Bioethics and Human Rights
Educational, S. A. C. O. U. N. (2006) · Jahrbuch für Wissenschaft und Ethik · doi:10.1515/9783110186406.377 · Cited by 467
The Limitations of “Vulnerability” as a Protection for Human Research Participants
Levine, C., Faden, R., Grady, C., Hammerschmidt, D., Eckenwiler, L., & Sugarman, J. (2004) · The American Journal of Bioethics · doi:10.1080/15265160490497083 · Cited by 438
VULNERABILITY IN RESEARCH AND HEALTH CARE; DESCRIBING THE ELEPHANT IN THE ROOM?
Hurst, S. (2008) · Bioethics · doi:10.1111/j.1467-8519.2008.00631.x · Cited by 410
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Vagueness, power and public health: use of ‘vulnerable’ in public health literature
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Metadata
- Authors
- Bracken-Roche, D., Bell, E., Macdonald, M. E., & Racine, E.
- Affiliations
- Montreal Clinical Research Institute (CA)
- McGill University (CA)
- Venue
- Health Research Policy and Systems
- Published
- 2017-02-07
- Volume
- 15
- Issue
- 1
- Pages
- 8-8
- ISSN
- 1478-4505 (ISSN-L)
- PMC
- PMC5297186
- OpenAlex
- W2587319655
- Cited by
- 283
- References
- 36
- Citations by year
- 2026: 23 · 2025: 29 · 2024: 29 · 2023: 47 · 2022: 42 · 2021: 38 · 2020: 28 · 2019: 24 · 2018: 9 · 2017: 10
- FWCI
- 18.23
- Type
- journal article
- Language
- en
- Update notices
- correction (2017-04-03)
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Health Research Policy and Systems (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship@McGill (McGill) (submittedVersion, cc-by)
- Funders
- Canadian Institutes of Health Research (97982)
- Fonds de Recherche du Québec - Santé (30998)
- Faculty of Medicine, McGill University (Internal Studentship 2015-16)
- 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, research ethics guidelines, Belmont Report, vulnerable populations, research ethics policy, research ethics committees, stakeholder engagement
- MeSH terms
- Clinical Trials as Topic, Health Policy, Humans, Informed Consent, International Cooperation, Practice Guidelines as Topic, Personal Autonomy, Ethics, Research, Biomedical Research, Vulnerable Populations
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