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Bioethics ; 27(6): 325-32, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23718852

ABSTRACT

This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities.


Subject(s)
Blood Banks , Blood Specimen Collection , Fetal Blood , Health Policy , Policy Making , Pregnant Women , Social Class , Vulnerable Populations , Argentina , Blood Banks/economics , Blood Banks/ethics , Blood Specimen Collection/economics , Blood Specimen Collection/ethics , Blood Specimen Collection/trends , Conflict of Interest , Educational Status , Emigrants and Immigrants , Female , Fetal Blood/transplantation , Health Literacy , Humans , Poverty , Pregnancy , Reproductive Rights , Transplantation, Autologous , Transplantation, Homologous , Uncertainty
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