title: Not the usual suspects: addressing layers of vulnerability.
abstract: This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities.
authors.affiliation: Programa de Bioética, Facultad Latinoamericana de Ciencias Sociales FLACSO, Sede Académica de Argentina, Ayacucho 555 CABA, Argentina. florlunaflacso@gmail.com
authors.forename: Florencia
authors.initials: F
authors.lastname: Luna
authors.forename: Sheryl
authors.initials: S
authors.lastname: Vanderpoel
mesh_terms: D001118:Argentina; D001771:Blood Banks / Q000191:economics / Q000941:ethics; D001800:Blood Specimen Collection / Q000191:economics / Q000941:ethics / Q000639:trends; D016265:Conflict of Interest; D004522:Educational Status; D054242:Emigrants and Immigrants; D005260:Female; D005312:Fetal Blood / Q000637:transplantation; D057220:Health Literacy; D006291:Health Policy; D006801:Humans; D011050:Policy Making; D011203:Poverty; D011247:Pregnancy; D037841:Pregnant People; D046269:Reproductive Rights; D012923:Social Class; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D035501:Uncertainty; D035862:Vulnerable Populations