Why are vulnerable populations considered vulnerable and to what are they vulnerable? (Select all that apply.)
a. Physical harm because of a preexistent mental or physical condition
b. The possibility of being assigned to the experimental group
c. Unethical researchers
d. Coercion
e. Diminished autonomy because of an impaired ability to consent
ANS: A, D, E
Some persons have diminished autonomy or are vulnerable and less advantaged because of legal or mental incompetence, terminal illness, or confinement to an institution. These persons require additional protection of their right to self-determination, because they have a decreased ability, or an inability, to give informed consent. In addition, these persons are vulnerable to coercion and deception. The U.S. DHHS has identified certain vulnerable groups of individuals, including pregnant women, human fetuses, neonates, children, mentally incompetent persons, and prisoners, who require additional protection in the conduct of research. Neonates are extremely vulnerable and require extra protection to determine their involvement in research. Some hospitalized patients are survivors of trauma (such as auto accidents, gunshot wounds, or physical and sexual abuse) who are very vulnerable and who often have decreased decision-making capacities. Sometimes students feel forced to participate in research to protect their grades or prevent negative relationships with the faculty conducting the research. Other subjects are coerced to participate in studies because they believe that they cannot refuse the excessive rewards offered, such as large sums of money, specialized health care, special privileges, and jobs.
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1. Stereotype him as a "dirty old man" and warn the rest of the staff to stay away from him. 2. Get a doctor's order for wrist restraints when nurses go near the patient, such as for dressings, baths, and feedings. 3. Maintain eye contact with the patient and then clearly tell him, and repeat, "I am your nurse, I am coming to help you eat, bathe, and change your stomach band-age. I am not Mary." 4. "That dressing needs changing. Don't be a naughty boy with me again or I will slap your hands and call Mary to come and do all your care herself!"