The term “vulnerable population” is used in the fields of healthcare, social services, counseling, and psychological research. Some government programs provide assistance for vulnerable populations. Vulnerable populations in the social work profession may refer to services offered to specific individuals, but more often, this term refers to ethical protocols that are necessary when research is conducted. Institutional Review Boards or IRBs put safeguards in place to ensure the well-being of vulnerable populations when research is designed and conducted.
Children, Infants and Fetuses
Children under age 18, including newborns and the not-yet-born or fetuses, are all considered protected categories and vulnerable populations for the purposes of medical or social science research. Child assent must be obtained prior to research, including the use of a child’s confidential medical records. Researchers must also obtain parental assent and permission. Child assent comes into play in situations where parents have agreed for a child to participate in research, but the child does not agree. As a member of a vulnerable population, the child’s decision is expected to prevail over the decision of parents and researchers. An unborn child or infant cannot agree to participate in an experiment, so in the case of research on fetuses or infants, both the Institutional Review Board (IRB) and parental choice will prevail.
Military veterans can become an overlooked population when medical or psychological research is being conducted. According to the Veterans Administration, veterans have a history of making sacrifices, taking orders, and may also experience post-traumatic stress disorder affecting their ability to consent to a study or experiment. Veterans also experience greater risk of health complications, higher mortality rates, and homelessness than the overall population.
Homeless and Incarcerated Populations
A crucial factor determining whether or not people are categorized as “vulnerable populations” is their ability to make informed decisions regarding participating in research. In the past, prisoners have been forced to participate in unethical medical or psychological research. Homeless men and women were also exposed to such unethical practices. One medical researcher promised homeless men meals and a warm bed in exchange for submitting to unethical and harmful cancer research. A Philadelphia physician notoriously performed painful, disfiguring skin experimentation on prisoners at Holmesburg Prison in his quest to invent and market Retin-A acne cream and other skin treatments.
Individuals With Low Levels of Education
Shocking, tragic violations of trust have taken place during research experiments on people who could not read or write well enough to understand legal documents. As recently as 1971 at the University of Cincinnati, physicians irradiated poorly educated African American study participants to discover the “side effects of radiation.” Some patients died within hours of receiving high radiation doses. The famous Tuskegee experiment exposed over 600 patients to syphilis. The patients were lied to and had no way to know they were not receiving free medical care, but instead had been infected with bacteria and were being monitored for signs and symptoms of the slow-acting sexually-transmitted infection.
The shocking research that exploited vulnerable populations in the past such as the Tuskegee experiment would never be conducted today. Institutional Review Boards review research proposals to ensure that a member of a vulnerable population can agree or disagree to participate in research at any time.