The Care of Vulnerability: The Proposal of an Ethical Space

Main Article Content

Linda Alfano
Paolo Fontana
Rosagemma Ciliberti

Keywords

vulnerability, ethics of care, bioethical decision-making, ethical space

Abstract


In recent years, the category of vulnerability has increasingly become the subject of attention from ethical, legal, and political reflections. Various events have shown how vulnerability cannot be considered a specific attribute of some individuals or certain segments of the population but belongs to all living beings by virtue of the deep interconnection between human beings and the ecosystem. This need for a relationship with others is precisely what has prompted a revision both of our concept of social responsibility, and of the taking care of the needs of the Other, within a holistic "One Health" vision based on the recognition that human, animal, and ecosystem health are all indissolubly linked.




Even in the medical and health care field has emerged a new relational dimension based on the recognition of the constant precariousness of the health-disease balance and the awareness of the connections between the person and the space they inhabit. And it is precisely thanks to this new approach that the homo independens, called to self-affirmation and total autonomy, has given way to the homo curans who, aware of the network of relationships they are part of, reaches out to others, towards an increasing valorization of a generative dimension of solidarity.




For this purpose, the authors analyze the proposal put forward by the National Bioethics Committee (NBC) to implement in Italy the so-called "Ethical Space": a place capable of offering the listening an welcoming of diverse life experiences in a protected relational context, free from the different dynamics of power and subjection, and capable of welcoming the discussion on ethical issues regarding health, giving voice both to health professionals and individual citizens and associations that represent them.


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References

1. Butler J. Frames of War: When Is Life Grievable? London: Verso; 2009.
2. Gordon BG. Vulnerability in Research: Basic Ethical Concepts and General Approach to Review. Ochsner J. 2020 Spring; 20(1):34–8.
3. Maeckelberghe E. Ethical implications of COVID-19: vulnerabilities in a global perspective. Eur J Public Health 2021; 31(4): iv50–iv53.
4. Martini M, Penco S, Baldelli I, Biolatti B, Ciliberti R. An ethics for the living world: Operation methods of animal ethics committees in Italy. Ann Ist Super Sanità 2015; 51(3):244–7.
5. Heidegger M. Being and Time (Translated by John Macquarrie & Edward Robinson). Oxford: Blackwell: 236. e 223; 2001.
6. Ricoeur P. Sé come un altro. D. Iannotta (Edited by). Milano: Jaca Book; 2020.
7. Tronto JC. Confini morali. Un argomento politico per l’etica della cura. Reggio Emilia: Diabasis; 2006.
8. Rogers W, Mackenzie C, Dodds S. Why bioethics needs a concept of vulnerability. Int J Fem Approaches Bioeth 2012; 5(2):11–38.
9. Jean T. Relations of Dependency and the Model of Rights. Public Rights, Private Relations. Oxford: Oxford University Press; 2015.
10. Kemp P, Rendtorff J D. The Barcelona Declaration. Towards an integrated approach to basic ethical principles. Synth Philos 2009; 23(2): 239–51.
11. Dakubo CY. Exploring the Linkages Between Ecosystems and Human Health. Ecosystems and Human Health 2010; 31:3–19.
12. Wardrope A. Relational Autonomy and the Ethics of Health Promotion, Public Health Ethics 2015; 8(1):50–62.
13. Gómez-Vírseda C, Usanos RA. Relational autonomy: lessons from COVID-19 and twentieth-century philosophy. Med Health Care and Philos 2021; 24: 493–505.
14. Pierosara S. Narrative Autonomy as Means of Vulnerability Management. Phainomena 2021; 30, (116-117): 99–122.
15. Giesinger J. Vulnerability and Autonomy – Children and Adults. Ethics Soc Welf 2019; 13(3):216–29.
16. de Castro R. Medicus-politicus, sive, De officiis medico-politicis tractatus, quator distinctus libris: in quibus non solum bonorum medicorum mores ac virtutes exprimuntur, malorum verò fraudes & impostura deteguntur : verum etiam pleraque, alia circa novum hoc argumentum nulia atque jucunda exactissimè proponuntur Hambourg: Ex Bibliopolio Frobeniano; 1614.
17. Ciliberti R, Alfano L, Baldelli I, De Stefano F, Bonsignore A. Self-determination, healthcare treatment and minors in Italian clinical practice: ethical, psychological, juridical and medical-legal profiles. Acta Biomed 2018; 8(1):34–40.
18. Freidson E. Professional dominance. The social structure of medical care. Abingdon: Taylor & Francis Inc; 2006.
19. Cosmi F, Brischetto R. Imparare la buona morte per viverla con amore. Milano: Edizioni LSWR; 2021.
20. Ciliberti R, Gulino M, Gorini I. New Italian law about end of life: Self-determination and shared care pathway. [La nuova normativa Italiana sul fine vita: L'autodeterminazione e la condivisione del percorso di cura]. Recenti Prog Med 2018; 109 (5): 267–71.
21. Getz L, Luise Kirkengen A, Hetlevik I. Too much doing and too little thinking in medical science!. Scand J Prim Health Care 2008; 26(2):65–6.
22. Pontificio Consiglio per gli Operatori Pastorali (Pastorale della Salute). Carta degli operatori sanitari 1995. https://salute.chiesacattolica.it/wp-content/uploads/sites/26/2016/10/CartaOperatoriSanitari.pdf
23. Biglu MH, Nateq F, Ghojazadeh M, Asgharzadeh A. Communication Skills of Physicians and Patients' Satisfaction. Mater Sociomed 2017; 29(3):192–5.
24. Horwitz RI, Lobitz G, Mawn M, Conroy AH, Cullen MR, Sim I, Singer BH. Biosocial medicine: Biology, biography, and the tailored care of the patient. SSM Popul Health 2021; 15:100863.
25. Busch IM, Moretti F, Travaini G, Wu AW, Rimondini M. Humanization of Care: Key Elements Identified by Patients, Caregivers, and Healthcare Providers. Syst Rev 2019; 12(5):461-74.
26. Patuzzo S, De Stefano F, Ciliberti R. The Italian code of medical deontology. Historical, ethical and legal issues. Acta Biomed 2018; 89(2):157–64.
27. Harrison. Principi di medicina interna. M. Vanoli & P. Riboldi (Edit by) New York: McGraw-Hill Companies; 2006.
28. Dehning S, Reiß S, Krause D, Gasperi S, Meyer S, Dargel S, Müller N, Siebeck M. Empathy in high-tech and high-touch medicine. Patient Educ Couns 2014; 95(2):259–64.
29. Battistuzzi L, Ciliberti R, Bruno W, Turchetti D, Varesco L, De Stefano F. Communication of clinically useful next-generation sequencing results to at-risk relatives of deceased research participants: Toward active disclosure? Clin Oncol 2013; 31(32):4164–5.
30. Battistuzzi L, Ciliberti R, Forzano F, De Stefano F. Regulating the communication of genetic risk information: The Italian legal approach to questions of confidentiality and disclosure. Clin Genet 2012; 82(3):205–9.
31. Montefiori M, di Bella E, Leporatti L, Petralia P. Robustness and Effectiveness of the Triage System in the Pediatric Context. Applied Health Economics and Health Policy 2017; 15(6):795–803.
32. Leneveu MC. L’Espace éthique: un lieu de passages… Éthique & Santé 2008; 5(4):241–4.
33. Ceretti A, Natali L. Cosmologie violente. Percorsi di vite criminali. Milano: Raffaello Cortina Editore; 2009.
34. Ceretti A, Bertagna G, Mazucato C. Il libro dell’incontro. Vittime responsabili della lotta armata a confronto. Milano: Il saggiatore; 2015.

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