Patients as more-than-ordinarily vulnerable people
To state that all patients are vulnerable is to do no more than recognise our common
human frailty. It would be more accurate to say that patients are more-than-ordinarily
vulnerable.
One aspect of those described as more-than-ordinarily vulnerable (as in ‘the vulnerable
adult’, ‘the vulnerable child’ and so on) is that such individuals are perceived by nurses
as not only at risk of harm because of an increased exposure to type 2 risks of harm but
also, in some cases, because of their reduced or absent capacity to recognise when they
are falling victim to the activities of abuse and/or because of their reduced or absent
capacity to look after their own interests if they become the victim of the activities of
abuse.
This distinction is important and is explained further. As a competent adult I am
vulnerable in ordinary everyday ways. As such I may fall victim to, for example, an
unscrupulous financial advisor who might choose to exploit my trust in the social
institutions that I anticipate will provide some measure of protection from exploitation.
I may be reassured by a claim by the financial advisor that he is a member of some
guild of financial advisors. It is quite likely that I will accept this claim at face value on
the grounds that I believe there to be such bone fide organisations designed to protect
individuals from rouge traders. If it turns out that there is no such guild and that I come
to recognise that I have been exploited then this will confirm my capacity to recognise,
albeit too late, that I have been duped. In addition, and because I am a competent adult,
I have the capability to find out how best to go about seeking recompense.
That I might not have taken all the steps available to me to protect myself from such
exploitation in the first place may have been the result of a naive trust in the system of
regulation of financial advisors and the worst that might be said is that I should have
checked to see if she or he was indeed a member of a bone fide financial services
regulatory authority. My failure to do so illustrates both my vulnerability to type 2 risks
of harm and the interdependence between type 1 and type 2 risks of harm. There is a
question that arises here in relation to the reasonableness of my actions of self-
protection. I have said that type 1 risks of harm can be categorised as offering the
opportunity to take actions which might have a reasonable chance of providing some
protection. I have also claimed that judgement is a necessary component of deciding
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