here are several definitions available for the term “vulnerable population”, the words simply imply the disadvantaged sub-segment of the community requiring utmost care, specific ancillary considerations and augmented protections in research (Shivayogi, 2013). The risk of a vulnerable population is the decreased freewill to inability to make informed choices. The vulnerable populations refers to but not limited to “children, minors, pregnant women, fetuses, human in vitro fertilization, prisoners, employees, military persons and students in hierarchical organizations, terminally ill, comatose, physically and intellectually challenged individuals, institutionalized, elderly individuals, visual or hearing impaired, ethnic minorities, refugees, international research, economically and educationally disabled and healthy volunteers” (Griffith, 2015). Ethical dilemmas are widely prevalent in research involving these populations with regard to communications, data privacy and therapeutic deliberations (Shivayogi, 2013). In this discussion board, I will focus on the avoidance of paternalism in healthcare.
Misuse of Power
The word paternalism also alludes to patriarchal power structures. Paternalism reduces the patient to a passive recipient of care and forces the patient to depend on the integrity and self-regulation of the providers (Cody, 2003). Certain persons are far more likely than others to be treated in a paternalistic manner. In regards to research, with respect to research involving children, incompetent adults, and other arguably vulnerable populations such as prisoners, there can be a misuse of power.
The Federal Policy for the Protection of Human Subjects or the “Common Rule” was published in 1991 to protect women, fetuses, children, and prisoners (Miller & Wertheimer, 2007). Common Rule outlines the basic requirements for IRBs, informed consent, and Assurances of Compliance. Last year, the Common Rule was revised for the first time since its publication in 1991 in order to strengthen protections for study participants. High on the list of priorities is helping people make better decisions about whether to participate in a clinical trial. One key goal: ensuring the risks and benefits of participation are clear. The need for the revision was because participant consents have become documents that protect the agency performing the procedure more than outlining the risks and benefits to the potential participant.
Nurse advocacy plays an important role in helping patients understand their rights and exercise their autonomy; protecting those who are vulnerable and advocating conscientious clinical and ethical research systems. A lack of informed consent (IC), with coercive, guileful, forceful influences and methods to secure potential participants results in deficient evidence-based health care (Griffith, 2015). NP’s are held to professional standards for professional practice and behavior in all areas of medicine.
Cody, W. K. (2003). Paternalism in Nursing and Healthcare: Central Issues and their Relation to
Theory. Nursing Science Quarterly, 16(4), 288–296. https://doi.org/10.1177/0894318403257170
Griffith, R. (2015). Understanding the Code: safeguarding vulnerable adults. British Journal Of
Community Nursing, 20(11), 564–566. https://doi-org.arbor.idm.oclc.org/10.12968/bjcn.2015.20.11.564
Miller, F. G., & Wertheimer, A. (2007). Facing up to paternalism in research ethics. The
Hastings Center Report, 37(3), 24–34. Retrieved from http://arbor.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=17649900&site=ehost-live&scope=site
Shivayogi P. (2013). Vulnerable population and methods for their safeguard. Perspectives in
clinical research, 4(1), 53-7.