Despite broad agreement that the vulnerable have a claim to special protection, defining vulnerable persons or populations has proved more difficult than we would like. This is a theoretical as well as a practical problem, as it hinders both convincing justifications for this claim and the practical application of required protections. In this paper, I review consent-based, harm-based, and comprehensive definitions of vulnerability in healthcare and research with human subjects. Although current definitions are subject to critique, their underlying assumptions may (...) be complementary. I propose that we should define vulnerability in research and healthcare as an identifiably increased likelihood of incurring additional or greater wrong. In order to identify the vulnerable, as well as the type of protection that they need, this definition requires that we start from the sorts of wrongs likely to occur and from identifiable increments in the likelihood, or to the likely degree, that these wrongs will occur. It is limited but appropriately so, as it only applies to special protection, not to any protection to which we have a valid claim. Using this definition would clarify that the normative force of claims for special protection does not rest with vulnerability itself, but with pre-existing claims when these are more likely to be denied. Such a clarification could help those who carry responsibility for the protection of vulnerable populations, such as Institutional Review Boards, to define the sort of protection required in a more targeted and effective manner. (shrink)

Self-trust is a necessary condition of personal autonomy and self-respect. Self-trust involves a positive sense of the motivations and competence of the trusted person; a willingness to depend on him or her; and an acceptance of vulnerability. It does not preclude trust in others. A person may be rightly said to have too much self-trust; however core self-trust is essential for functioning as an autonomous human being.

Imagine you are walking down a city street. It is windy and raining. Amidst the bustle you see a young woman. She sits under a railway bridge, hardly protected from the rain and holds a woolen hat containing a small number of coins. You can see that she trembles from the cold. Or imagine seeing an old woman walking in the street at dusk, clutching her bag with one hand and a walking stick with the other. A group of male (...) youths walk behind her without overtaking, drunk and in the mood for mischief. It doesn't need an academic to say what vulnerability is. We can all see it, much more often than we care to. (shrink)

Calls to expand temporary work programmes come from two directions. First, as global justice advocates observe, every year thousands of poor migrants cross borders in search of better opportunities, often in the form of improved employment opportunities. As a result, international organizations now lobby in favour of expanding ‘guest-work’ opportunities, that is, opportunities for citizens of poorer countries to migrate temporarily to wealthier countries to fill labour shortages. Second, temporary work programmes permit domestic governments to respond to two internal, contradictory (...) political pressures: (1) to fill labour shortages and (2) to do so without increasing rates of permanent migration. Temporary work programmes permit governments to appear ‘tough’ on migration, while responding to employer pressure to locate workers willing to work in low-skilled, poorly remunerated positions. The coincidence of national self-interest and global justice generates a strong case in favour of expanding guest-work. We evaluate the moral benefits and burdens of expanding guest-work opportunities, and conclude that although there are benefits to be gleaned from the perspective of global wealth redistribution, at present, temporary work programmes are generally unjust. We will argue that just temporary work programmes, in time, permit temporary workers to attain citizenship. This spells the end of traditional temporary work programmes, which require that workers return to their home country in time; instead, what is temporary is the employment obligation that must be fulfilled as a requirement to access citizenship. As long as this requirement is met, we endorse guest-work programmes as a tool to respond to global inequality. (shrink)