The idea of vulnerability in healthcare law and ethics : from the margins to the mainstream?

Neal, Mary; Bedford, Daniel and Herring, Jonathan, eds. (2020) The idea of vulnerability in healthcare law and ethics : from the margins to the mainstream? In: Embracing Vulnerability. Routledge, Abingdon, Oxon. ISBN 9781138476929

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Abstract

Without vulnerability, there would be no need for healthcare, or law, or ethics. Each of these systems owes its existence to the fact that human beings are open, fragile, and fallible. The idea of vulnerability might seem to deserve a prominent place in thinking and writing about healthcare law and ethics, therefore. But what exactly do we mean by ‘vulnerability’ when we refer to it in the context of healthcare law and ethics (HCLE), and what should we mean by it? Must the theory and practice of HCLE adopt an understanding of vulnerability that applies in other contexts too, or should we be seeking a bespoke concept of vulnerability particular to the HCLE setting? The idea of vulnerability has had a chequered history in HCLE literature. It has figured mainly at the margins of the discourse, where it has tended to be associated with risk, harm, and exploitation, and seen as something undesirable to be minimised or eliminated. Since the turn of the millennium, however, there has been a pronounced shift toward more direct, explicit engagement with the idea of vulnerability. In this chapter, I will begin by using a Wittgensteinian approach to enquire into what ‘vulnerability’ currently means in the context of healthcare law and ethics (HCLE). I will observe that the meaning of vulnerability in healthcare law and ethics is in flux and suggest that, although our thinking, talking, and writing about healthcare seems to be progressing toward a more appropriate engagement with the idea of vulnerability, now would be an appropriate moment to take stock of developments. In the latter part of the chapter I will offer some clarifications, draw some key distinctions, and emphasise some important themes, in order to facilitate the development of our understanding.