Philosophical Perspectives on Trustworthiness and Open-mindedness as Professional Virtues for the Practice of Nursing: Implications for he Moral Education of Nurses

occasion dependent upon a range of factors only some of which are amenable to our
individual influence.

If all people are vulnerable then it must be true that all patients are vulnerable, and if all
patients are vulnerable then there is little point in describing some individual patients or
groups of patients as vulnerable for that is merely to state the obvious. The best that
might be said is that to use the phrase ‘vulnerable patient’ is to use a form of shorthand
on the assumption that common understandings exist about what such a claim actually
means. Thus ‘the vulnerable adult’ may be shorthand for ‘an adult who is at high risk of
a particular sort of harm or set of harms as a direct result of her or his particular
vulnerability at a particular point in time’ or for ‘an adult who is vulnerable in ways that
are beyond what we take to be ordinary human vulnerability’. This reinforces the idea
that all clients are vulnerable but that some clients’ vulnerability is such that they are
more likely to suffer harm from particular and predictable sources. On this account one
of the responsibilities of the nurse is to know both what those sources are and how to
offer suitable and appropriate protection, insofar as such measures are possible and
reasonable. It also emphasises the fact that to be vulnerable is to be vulnerable to
something.

It is worth noting at this point that this is not a claim for a single 'technical' definition of
vulnerability. Rather it is to note current use is imprecise and ambiguous. Nurses from
different branches of nursing (as well as nurses from within the same branch of nursing)
may well have different ideas about which individuals or groups are or are not
vulnerable. However there is a generally accepted idea that there are individuals who
are particularly vulnerable, that is, at risk of certain sorts of harms and/or abuse and that
this vulnerability is one of the things that identifies an individual as a client.

The idea that some clients require more protection than others is evident in many
nursing accounts. The list of vulnerable adults would include, among others, individuals
with learning difficulties, those undergoing cytotoxic chemotherapy for cancer, those
with mental health problems and those in intensive care.

In this chapter I explore the meaning of vulnerability both in general terms and in the
context ofhealth care in the attempt to bring some clarity to the use of the term in
nursing. I make a distinction between ordinary and extra-ordinary vulnerability and

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