Derek Seliman
Risks of harm
In terms of an individual’s capacity to reduce her or
his vulnerability it is possible to determine three dif-
ferent types of risks of harm.
Type I risks of harm
Those risks of harm against which an individual has
the opportunity to take actions that have a reasonable
chance of providing some protection. So walking on
the pavement normally reduces the risk of harm to
individual pedestrians from road traffic.
Type 2 risks of harm
Those risks of harm against which an individual must
rely for protection (such as is available) on the actions
of others. This may be a reliance on individual others
or on some form of institutionalized others. So the
pedestrian is protected by the individual other in the
form of the driver who drives with sufficient care and
attention, as well as institutionalized others in the
form of various social or political institutions that
have been developed for the purpose. Thus in the UK
the risks of harm associated with motor vehicle use
are reduced by institutionalized regulations, such as
the highway code, Ministry of Transport testing, seat
belt laws and so on.
Type 3 risks of harm
Those risks of harm against which an individual is,
generally speaking, powerless to protect her or him-
self regardless of the actions of others. Harms that
occur as a result of the unexpected or unanticipated
events (what insurance companies tend to describe as
‘acts of God’), which allow only limited scope for
effective action, would fit this category. The earth-
quake that destroys a road causing damage to cars
and injury to occupants is the sort of event to which
we are vulnerable but against which we are, generally
speaking, defenceless.
Tliis categorization serves two purposes. It offers a
counter to any Stoic tendency toward fatalism by
providing a guide by which we might determine
whether an action has a reasonable chance of reduc-
ing our vulnerability. So if I am concerned about a
particular risk of harm and I believe that risk to be a
type 1 risk (as described above) I might be more
tempted to act to protect myself than if it were a type
3 risk. It also illustrates both the scope and the limi-
tations of our individual and/or institutional inter-
ventions in any attempt to reduce or minimize our
vulnerability.
The categorization has only limited application for
it will be immediately apparent that each of the three
types of risks of harm identified above are likely to
be influenced by aspects of one or both of the other
two.
... but some people are more
vulnerable than others
I have noted earlier that we are at times more
vulnerable as a normal part of our general everyday
vulnerability. But there are other times when we
might be more vulnerable in поп-everyday ways. Peo-
ple debilitated in these ways are more-than-ordinarily
vulnerable.
On this account those whose mental development
does not match their physical development, those
who are likely to fall asleep at any time of day while
undertaking any activity, and those who become so
distracted that it interferes with their normal every-
day functioning are all more-than-ordinarily vulnera-
ble. And it is reasonable to suppose that when we
require the services of health care workers in general
and of nurses in particular we are or have become
more-than-ordinarily vulnerable.
The purpose of differentiating between these two
senses of vulnerability is twofold. It provides a basis
for establishing the meaning of the technical, but
often unarticulated, way in which the term vulnera-
ble is employed to categorize particular groups and
individuals, and it also serves as a reminder of our
shared human frailty. Although it should be noted
that ordinary people with ordinary vulnerabilities do
flourish in the world. To describe some individuals
and groups as vulnerable suggests that others are in
some sense invulnerable, or non-vulnerable - a
claim that cannot be sustained. What follows from
© Blackwell Publishing Ltd 2005 Nursing Philosophy, 6, pp. 2-Ю
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