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REACH Publications and Resources

Journal papers

  • Zakayo SM, Njeru RW, Sanga G, et al. Vulnerability and agency across treatment-seeking journeys for acutely ill children: how family members navigate complex healthcare before, during and after hospitalisation in a rural Kenyan setting. Int J Equity Health. 2020;19(1):136. Published 2020, Aug 10.
  • Khirikoekkong N, Jatupornpimol N, Nosten S, Asarath S, Hanboonkunupakarn B, McGready R, Nosten F, Roest J, Parker M, Kelley M, Cheah PY. Research ethics in context: understanding the vulnerabilities, agency and resourcefulness of research participants living along the Thai–Myanmar border, International Health, Volume 12, Issue 6, November 2020, Pages 551–559,
  • Nkosi B, Seeley J, Chimbindi N, Zuma T, Kelley M, Shahmanesh M, Managing ancillary care in resource-constrained settings: Dilemmas faced by frontline HIV prevention researchers in a rural area in South Africa, International Health, Volume 12, Issue 6, November 2020, Pages 543–550,
  • Muraya, K., Ogutu, M., Mwadhi, M. et al. Applying a gender lens to understand pathways through care for acutely ill young children in Kenyan urban informal settlements. Int J Equity Health 20, 17 (2021).
  • Uddin, M.F., Molyneux, S., Muraya, K. et al. Gender-related influences on adherence to advice and treatment-seeking guidance for infants and young children post-hospital discharge in Bangladesh. Int J Equity Health 20, 64 (2021).
  • Zakayo SM, Kimani MN, Sanga G, et al. Vulnerability, Agency, and the Research Encounter: Family Members’ Experiences and Perceptions of Participating in an Observational Clinical Study in Kenya. Journal of Empirical Research on Human Research Ethics. March 2021.
  • Molyneux SSukhtankar PThitiri J, et al. Model for developing context-sensitive responses to vulnerability in research: managing ethical dilemmas faced by frontline research staff in Kenya. BMJ Global Health 2021;6: e004937.
  • Nkosi B, Seeley J, Chimbindi N, Zuma T, Kelley M, Shahmanesh M. Putting research ethics in context: Rethinking vulnerability and agency within a research ethics case study on HIV prevention for young girls in South Africa, SSM - Qualitative Research in Health, Volume 2, April 2022,

Online resources & Galleries


Recommended Journal Papers

  • Thoits, Peggy A. "Stress, coping, and social support processes: Where are we? What next?" Journal of health and social behavior (1995): 53-79.
  • Thompson, Suzanne C., and Shirlynn Spacapan. "Perceptions of control in vulnerable populations." Journal of Social Issues 47, no. 4 (1991): 1-21.
  • Vig, Susan, Susan Chinitz, and Lisa Shulman. "Young children in foster care: Multiple vulnerabilities and complex service needs." Infants & Young Children 18, no. 2 (2005): 147- 160.
  • Wang, Caroline C. "Photovoice: A participatory action research strategy applied to women's health." Journal of Women's Health 8, no. 2 (1999): 185-192. World Medical Association.


Recommended Reading


  • Goodin, Robert E. Protecting the vulnerable: A re-analysis of our social responsibilities. University of Chicago Press, 1985.
  • MacKenzie C, Rogers W, Dodds S, eds. Vulnerability: New Essays in Ethics and Feminist Philosophy. Oxford University Press, 2014


  • Kelley M, James C, Kraft SA, Korngiebel D, Wijangco I, Rosenthal E, et al. Patient perspectives on the learning health system: the importance of trust and shared decision making. American Journal of Bioethics 15, no.6 (2015): 4-17.
  • Kerber, KJ, de Graft-Johnson, JE, Bhutta Z, Okong P, Starrs A, Lawn JE. Continuum of care for maternal, newborn, and child health: from slogan to service delivery. The Lancet 370, no.  9595  (2007):1358-1369.
  • Kipnis, K. “Seven Vulnerabilities in the Pediatric Research Subject.” Theoretical Medicine and Bioethics 24, no.2 (2003): 107-120.  
  • Kipnis, K. “Vulnerability in Research Subjects: A Bioethical Taxonomy.” In: National Bioethics Advisory Commission [NBAC]. Ethical and Policy Issues in Research Involving Human Participants. Volume II: Commissioned Papers. Rockville, MD: National Bioethics Advisory Commission [NBAC]; 2001: G1-G13.
  • Kottow, Michael H. "The vulnerable and the susceptible." Bioethics 17, no. 5-6 (2003): 460- 471.
  • Lange, Margaret Meek, Wendy Rogers, and Susan Dodds. "Vulnerability in research ethics: away forward." Bioethics 27, no. 6 (2013): 333-340.
  • Lee SS, Kelley M, Cho M, Kraft SA, James C, Constantine M, et al. Adrift in the gray zone: IRB perspectives on research in the learning health system. AJOB Empirical Bioeth. In press, 2015.
  • Levine, C, Ruth F, Christine G, Hammerschmidt D, Eckenwiler L, and Sugarman J. "The limitations of “vulnerability” as a protection for human research participants." The American Journal of Bioethics 4, no. 3 (2004): 44-49.
  • Lotz, Mianna. “Vulnerability and Resilience: a Critical Nexus.” Theoretical Medicine and Bioethics 37, no.1 (2016):45-59.
  • Luna F. Elucidating the Concept of Vulnerabilitiy: Layers not Labels. International Journal of Feminist Approaches to Bioethics 2, no.1 (2009):121-139.
  • Luna, F, Vanderpoel, S. “Not the Usual Suspects: Addressing Layers of Vulnerability” Bioethics 27, no.6 (2013): 325-332.
  • Lyerly AD, Little MO, Faden R. The second wave: Toward responsible inclusion of pregnant women in research. International Journal of Feminist Approaches to Bioethics 2008;1:5-22.
  • Matthews, S, Tobin, B. “Human Vulnerability in Medical Contexts.” Theoretical Medicine and Bioethics 37, no.1 (2016): 1-7.
  • Macklin, R. “Bioethics, Vulnerability, and Protection.” Bioethics 17, no.5-6  (2003): 472-486.
  • Martin, A.K. “Resolving the Conflict: Clarifying ‘Vulnerability’ in Health Care Ethics.” Kennedy Institute of Ethics Journal 24, no.1 (2014): 51-72.
  • Mastroianni AC FR, Federman D. Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies. IOM 1994. McNeil, GF (2015) A Failed Trial in Africa Raises Questions about How to Test HIV Drugs. New York Times. New York, The New York Times Company.
  • Mayes, C., Blakely, B., Kerridge, I., Komesaroff, P., Olver, I., Lipworth, W. “On the Fragility of Medical Virtue in a Neoliberal Context: The Case of Commercial Conflicts of Interest in Reproductive Medicine.” Theoretical Medicine and Bioethics 37, no.1 (2016): 97-111.
  • McConnell, D. “Narrative Self-Constitution and Vulnerability to Co-Authoring.” Theoretical Medicine and Bioethics 37, no.1 (2016): 29-43.
  • Nickel, P.J. “Vulnerable Populations in Research: The Case of the Seriously Ill.” Theoretical Medicine and Bioethics 27, no.3 (2006): 245-264.
  • Nyambedha, Erick Otieno. "Ethical dilemmas of social science research on AIDS and orphanhood in Western Kenya." Social Science & Medicine 67, no. 5 (2008): 771-779.
  • Oakley, J. “Diagnosing True Virtue? Remote Scenarios, Warranted Virtue Attributions, and Virtuous Medical Practice.” Theoretical Medicine and Bioethics 37, no.1 (2016): 85-96.
  • Quilter, JG. “The New Enhancement Technologies and the Place of Vulnerability in our Lives.” Theoretical Medicine and Bioethics 37, no.1 (2016): 9-27.
  • Rendtorff, J.D. “Basic Ethical Principles in European Bioethics and Biolaw: Autonomy, Dignity, Integrity, and Vulnerability – Towards a Foundation of Bioethics and Biolaw.” Medicine, Health Care and Philosophy 5, no.3 (2002):235-244.
  • Rogers, W.A., Walker, M.J. “Fragility, Uncertainty, and Healthcare.” Theoretical Medicine and Bioethics 37, no.1 (2016): 71-83.
  • Rogers, W., Mackenzie, C., Dodds, S. “Why Bioethics Needs A Concept of Vulnerability.” International Journal of Feminist Approaches to Bioethics 5, no.2 (2012): 11-38.
  • Schroeder, D., Genefas, E. “Vulnerability: Too Vague and Too Broad.” Cambridge Quarterly of Healthcare Ethics 18, no. 2 (2009):113-121.
  • Schuklenk, U. “Protecting the Vulnerable: Testing Times for Clinical Research Ethics.” Social Science and Medicine 51, no.6 (2000): 969-977.
  • Solbakk, J.H. “Vulnerability: A Futile or Useful Principle in Healthcare Ethics?” In Chadwick, R., Have, H.T., and Meslin, E.M. (Eds.) The SAGE Handbook of Health Care Ethics: Core and Emerging Issues, SAGE, 2011: 228-238.
  • Stone, T.H. “Currents in Contemporary Ethics.” Journal of Law, Medicine, and Ethics. 31, no.1 (2003):149- 153.
  • Tavaglione, N., Martin, A.K., Mezger, N., Durieux-Paillard, S., Francois, A., Jackson, Y., and Hurst, S.A. “Fleshing out Vulnerability.” Bioethics 29, no.2 (2015): 98-107.


Recommended Guidelines

  • Nuffield Council on Bioethics. The ethics of research related to health care in developing countries. London: Nuffield Council on Bioethics, 2002.
  • Council for International Organizations of Medical Sciences (CIOMS) in collaboration with the World Health Organization (WHO). 2016. International Ethical Guidelines for Health-Related Research involving Humans. Geneva, Switzerland.  Available for download at:
  • National Commission for the Protection of Human Subjects, The Belmont Report. (1979). The report to the Secretary of the Department of Health, Education and Welfare.

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