Vulnerability is susceptibility to any kind of harm, whether physical, moral or spiritual, at the hands of an agent or agency. It is related to disempowerment and loss of autonomy. It is also a relational category that appears repeatedly in the narratives of colorectal cancer patients and their carers. Although one conventionally associates vulnerability with being ill and needing health care, the practice of health care has its own vulnerabilities that emerge as important in the biographies of health care workers. Vulnerability needs to be recognized and negotiated in health care transactions. This article examines a process of ‘reading-for’ vulnerability, and suggests a classification of vulnerability, at least as it appears in the narratives of cancer patients and their carers. Methods of managing vulnerability are also examined and categorized. Reading for vulnerability brings insight into an important aspect of the health care process. Recognition of its importance should translate into changes in medical education and patient information.
Agich, G.J. (1993). Autonomy and long-term care. Oxford: Oxford University Press.
2.
Baemayr, A. and Feuerlein, W. (1986). Incidence of suicides among medical doctors and dentists in Upper Bavaria. Social Psychiatry, 21(1), 39–48.
3.
Baier, A.C. (1995). Trust and antitrust. Moral prejudices: Essays on ethics. Cambridge, MA: Harvard University Press.
4.
Beauchamp, T.L. and Childress, J.F. (1989). Principles of biomedical ethics. Oxford: Oxford University Press.
5.
Campbell, A. , Charlesworth, M., Gillett, G. and Jones, G. (1997). Medical ethics. Oxford: Oxford University Press.
6.
Carpenter, L.M. , Swerdlow, A.J. and Fear, N.T. (1997). Mortality of doctors in different specialties: Findings from a cohort of 20000 NHS hospital consultants. Occupational and Environmental Medicine, 54(6), 388–395.
7.
Clifford, V.A. (1998). Looking after patients and doctors. In A. Petersen and C. Waddell (Eds.), Health matters:A sociology of illness, prevention and care, pp. 240–255. St Leonards, Sydney: Allen & Unwin.
8.
Crossley, M.L. (1997). ‘Survivors’ and ‘victims’: Long-term HIV positive individuals and the ethos of self-empowerment. Social Science & Medicine, 45(12), 1863–1873.
9.
David, J.L. and Kaplan, H.B. (1995). Gender, social roles and health care utilization. Applied Behavioral Science Review, 3(1), 39–64.
10.
Demi, A.S. and Warren, N.A. (1995). Issues in conducting research with vulnerable families. Western Journal of Nursing Research, 17(2), 182–202.
11.
Downie, R.S. and Charlton, B. (1992). The making of a doctor: Medical education in theory and practice. Oxford: Oxford University Press.
12.
Foucault, M. (1980). Power/knowledge: Selected interviews and other writings 1972–1977. London: Harvester Press.
13.
Frank, A.W. (1995). The wounded storyteller: Body, illness, and ethics. Chicago, IL: Chicago University Press.
14.
Frank, A.W. (1998). Stories of illness as care of the self: A Foucauldian dialogue. Health, 2(3), 329–348.
15.
Griffith, P.J. (1997). Medical and social dynamics of college women’s interactions with their gynecologists. Sociological Inquiry, 67(4), 397–408.
16.
King, J. (1982). The patient’s dilemma. New Society, 59(1008), 388–389.
17.
Kleinman, A. (1988). The illness narratives: Suffering, healing and the human condition. New York: Basic Books.
18.
Koehn, D. (1994). The ground of professional ethics. London: Routledge.
19.
Levinas, E. (1989). Ethics as first philosophy. In S. Hand (Ed.), The Levinas reader, p. 84-84. Oxford: Blackwell.
20.
Little, M. , Jordens, C.F.C., Paul, K., Montgomerey, K. and Philipson, B. (1998). Liminality: A major category of the experience of cancer illness. Social Science & Medicine, 47(10), 1485–1494.
21.
Little, M. , Jordens, C.F.C., Paul, K., Sayers, E.-J. and Sriskandarajah, D. (1999). Approval and disapproval in the narratives of patients with colorectal cancer and their carers. Health, 3(4), 451–467.
22.
Loevenich, A. , Schmidt, R. and Schifferdecker, M. (1997). Doctors as patients: The problem of the mentally ill physician. Fortschritte der Neurologie-Psychatrie, 64(9), 344–352.
23.
Mackerras, P. (1996). Medicine:A guide for prospective students. Canberra: Australian Government Publishing Service.
24.
Manne, S.L. and Zautra, A.J. (1990). Couples coping with chronic illness: Women with rheumatoid arthritis and their healthy husbands. Journal of Behavioral Medicine, 13(4), 327–342.
25.
Mishler, E.G. (1996). Research interviewing: Context and narrative. Cambridge, MA: Harvard University Press.
26.
Mumby, D.K. (1997). Modernism, postmodernism, and communication studies: A rereading of an ongoing debate. Communication Theory, 7(1), 1–28.
27.
Myers, M. (1994). Doctors’ marriages:A look at the problems and their solutions. New York: Plenum Medical Book Co.
28.
Norton, K. and Smith, S. (1994). Problems with patients: Managing complicated transactions. Cambridge: Cambridge University Press.
29.
Patz, J.A. and Jodrey, D. (1995). Occupational health in surgery: Risks extend beyond the operating room. Australian and New Zealand Journal of Surgery, 65(9), 627–629.
30.
Pollack, B.R. (1989). Teaching law, ethics, and risk management at the School of Dental Medicine State University of New York at Stony Brook. Journal of Law & Ethics in Dentistry, 2(1), 32–49.
31.
Radley, A. (1999). Abhorrence, compassion and the social response to suffering. Health, 3(2), 167–187.
32.
Randall, F. and Downie, R.S. (1996). Palliative care ethics:A good companion. Oxford: Oxford University Press.
33.
Riis, P. (1995). Research ethics: A widening of the scope and extrapolation into the future. Journal of Internal Medicine, 238(6), 521–529.
34.
Seligman, A.B. (1997). The problem of trust. Princeton, NJ: Princeton University Press.
35.
Stewart, M. , Tudiver, F., Bass, M.J., Dunn, E.V. and Norton, P.G. (Eds.). (1992). Tools for primary care research. Newbury Park, CA: Sage Publications.
36.
Stone, E.J. (1977). The effects of a health education curriculum on locus of control, perceived vulnerability, and health attitudes of fifth grade students. Dissertation Abstracts International, 38(2-A), 646–647.
37.
Turner, J.T. (1988). Hostage-takers in health care settings. Psychiatric Clinics of North America, 11(4), 649–664.
38.
Verbrugge, L.M. (1989). The twain meet: Empirical explanations of sex differences in health and mortality. Journal of Health & Social Behavior, 30(3), 282–304.
39.
Wear, S. (1993). Informed consent: Patient autonomy and physician beneficence within clinical medicine. Dordrecht: Kluwer Academic Publishers.
