| Literature DB >> 28372567 |
Dearbhail Bracken-Roche1,2, Emily Bell1, Mary Ellen Macdonald3, Eric Racine4,5,6,7.
Abstract
Entities:
Year: 2017 PMID: 28372567 PMCID: PMC5377024 DOI: 10.1186/s12961-017-0186-8
Source DB: PubMed Journal: Health Res Policy Syst ISSN: 1478-4505
Vulnerable groups identified in our sample, as well as explanations for this designation, where available
| Vulnerable Group (Mentioned in) | Explanation |
|---|---|
| Grouped by social status or situation | |
| Prisoners (CIOMS, ICH GCP, Aus. National Statement, TCPS2, Common Rule) | Vulnerable because: |
| Certain ethnic, racial minority, or ethnocultural groups (CIOMS, ICH GCP, TCPS2, Belmont Report) | Vulnerable because: |
| Patients in emergency settings, prospective participants for emergency research (CIOMS, Clinical Trials Regulation, ICH GCP, TCPS2) | Vulnerable because: |
| Subordinate members of hierarchies or relationshipsc (CIOMS, ICH GCP, Aus. National Statement) | Vulnerable because: |
| Economically disadvantaged persons (Belmont Report, Common Rule) | Vulnerable because: |
| Homeless persons (CIOMS, ICH GCP) | •Explanation unclear [18, 22] |
| Institutionalized persons (TCPS2, Belmont Report) | Vulnerable because: |
| Nomads (CIOMS, ICH GCP) | •Explanation unclear [18, 22] |
| Persons in nursing homes (CIOMS, ICH GCP) | •Explanation unclear [18, 22] |
| Persons lacking political or social power (CIOMS) | •Explanation unclear [18] |
| Refugees or displaced persons (CIOMS, ICH GCP) | •Explanation unclear [18, 22] |
| Women (CIOMS, TCPS2) | Vulnerable to: |
| Countries or communities with limited resources (CIOMS) | Vulnerable to: |
| Educationally disadvantaged persons (Common Rule) | Vulnerable to: |
| Members of communities unfamiliar with modern medical concepts (CIOMS) | •Explanation unclear [18] |
| Neonates in intensive care (Aus. National Statement) | Vulnerable because: |
| Patients in terminal care (Aus. National Statement) | Vulnerable to: |
| Participants and researchers in research that uncovers illegal activities (Aus. National Statement) | Vulnerable because: |
| Those with diminished capacity for self-determination (TCPS2) | •Historically vulnerable and “have, at times, been treated unfairly and inequitably in research, or have been excluded from research opportunities”a ([24], p. 8) |
| The least organizationally developed communities (TCPS2) | Vulnerable to: |
| Grouped by patient/ participant condition | |
| Children, minors, or young people (CIOMS, Clinical Trials Directive, Clinical Trials Regulation, Aus. National Statement, TCPS2, Common Rule) | Vulnerable because: |
| Persons with mental illness or mental health problems (Clinical Trials Regulation, Aus. National Statement, TCPS2, UK Research Governance Framework) | Vulnerable because: |
| Elderly persons (CIOMS, Clinical Trials Regulation, TCPS2) | Vulnerable because: |
| Persons with limited (or no) freedom or capacity to consent (CIOMS, Clinical Trials Regulation, ICH GCP) | Vulnerable because: |
| Pregnant or breastfeeding women (Clinical Trials Regulation, Common Rule) | Vulnerable to: |
| Adults with learning difficulties (UK Research Governance Framework) | •No explanation [25] |
| Handicapped persons (Common Rule) | •No explanation [27] |
| Mentally disabled persons (Common Rule) | Vulnerable to: |
| Persons who have serious, potentially disabling or life-threatening diseases (CIOMS) | Vulnerable because: |
| Very sick persons (Belmont Report) | Vulnerable because: |
| People suffering from multiple chronic conditions (Clinical Trials Regulation) | •No explanation [21] |
| Persons with a cognitive impairment or intellectual disability (Aus. National Statement) | Vulnerable to: |
aIt is not clear whether the TCPS2 intends these groups it refers to as having been historically in vulnerable circumstances as still at risk of this. Given that this is mentioned but not negated, we included these groups in our table
bThe Belmont Report lists a number of vulnerable groups and a series of explanations of their vulnerability. It is unclear whether certain groups were intended to be linked to certain explanations, so all have been included
cWithin this category, specific subject groups are provided as examples. For the CIOMS these are “medical and nursing students, subordinate hospital and laboratory personnel, employees of pharmaceutical companies, and members of the armed forces or police” ([18], p. 65). The ICH GCP adds pharmacy and dental students and persons kept in detention to this list [22]. The Australian National Statement lists “carers and people with chronic conditions or disabilities, including long-term hospital patients, involuntary patients, or people in residential care or supported acumination; health care professionals and their patients or clients; teachers and their students; prison authorities and prisoners; governmental authorities and refugees; employers or supervisors and employees (including members of the Police and Defence forces); service-providers (government or private) and especially vulnerable communities to whom the service is provided” ([23], p. 53)
The table is grouped by category, and organized by the number of times a group is mentioned in the policies and guidelines