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

protective actions by and for ourselves) might be said to be ordinarily vulnerable and
hence have the potential to flourish. This is to say that, if such a person chooses to
pursue the good life then there would seem to be little in the way of external obstacles
that would prevent them from so doing. Whereas, a person whose protective capacities
are compromised and who lives with the continual threat of type 2 risks of harm (those
against which she or he must rely on the actions of others for protection) will have more
obstacles to overcome if they are to flourish. This is particularly the case either where
those others cannot be trusted to provide some degree of protection or where the
individual perceives that the social and political institutions cannot be relied upon to act
for the public good. People whose vulnerability is exposed to type 3 risks of harm
(those against which there is little human intervention that can have an effect) have even
less opportunity to thrive regardless of their own capacitates for self protection. And
being more-than-ordinarily vulnerable compromises the possibility of human
flourishing in ways that being ordinarily vulnerable does not.

People who are or who become recipients of health care in general and nursing care in
particular can therefore be considered, at least in general terms, more-than-ordinarily
vulnerable because their exposure to type 2 and/or type 3 risks of harm has increased,
and because their capacities for self protection are compromised. The further the
balance of types of risks of harm moves towards types 2 and 3 risks for any given
person the greater the threat and likelihood of harm precisely because of they are more-
than-ordinarily vulnerable. Thus all patients can be considered as more-than-ordinarily
vulnerable. This is not to deny differences of degree in being more-than-ordinarily
vulnerable and as such some patients will be at greater risk than others just as some
ordinarily vulnerable persons are more at risk than others.

Patients as vulnerable people

Current descriptions of certain patients or groups of patients as vulnerable remain
unsatisfactory for at least two reasons. One reason is the ambiguity that can arise when
different understandings of the term-in-use collide; a second reason takes the form of a
recognition of the different susceptibilities of individual patients.

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