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      APROXIMACIONES AL CONCEPTO DE VULNERABILIDAD DESDE LA BIOÉTICA: UNA REVISIÓN INTEGRADORA Translated title: APPROACHES TO THE CONCEPT OF VULNERABILITY FROM BIOETHICS: AN INTEGRATIVE REVIEW Translated title: ABORDAGENS SOBRE O CONCEITO DE VULNERABILIDADE A PARTIR DA BIOÉTICA: UMA REVISÃO INTEGRATIVA

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          Abstract

          Resumen Para dar cuenta de la revisión integradora de literatura sobre el concepto de vulnerabilidad desde la bioética se analizó un corpus de 60 artículos publicados en español, inglés y portugués. Esto permitió identificar las tendencias temáticas: riesgo, susceptibilidad, autonomía y cultura en personas y comunidades; la aproximación metodológica ha sido mayormente desde un enfoque cualitativo; las disciplinas que más abordaron el concepto pertenecen a las ciencias humanas y sociales; los autores recomiendan realizar estudios del concepto desde la perspectiva de las personas y que los comités de ética revisen el consentimiento informado y las guías de información de acuerdo con estos resultados. Las categorías dan paso al concepto de vulnerabilidades, que en la bioética debe ser analizado más allá del principialismo.

          Translated abstract

          Abstract A corpus of 60 articles published in Spanish, English, and Portuguese was analyzed to account for the integrative literature review on the concept of vulnerability from bioethics, identifying the following thematic trends: risk, susceptibility, autonomy, and culture in people and communities. The methodological approach has been mainly qualitative. We found that the disciplines that most addressed the concept belong to the human and social sciences. The authors recommend conducting studies of the concept from people's perspectives and that ethics committees review the informed consent and information guides according to these results. The categories give way to the concept of vulnerability, which must be analyzed beyond principlism in bioethics.

          Translated abstract

          Resumo Para dar conta da revisão integrativa da literatura sobre o conceito de vulnerabilidade a partir da bioética, foi analisado um corpus de 60 artigos publicados em espanhol, inglês e português. Isso permitiu identificar tendências temáticas: risco, suscetibilidade, autonomia e cultura em pessoas e comunidades. A abordagem metodológica foi predominantemente qualitativa; por sua vez, as disciplinas que mais abordaram o conceito pertencem às ciências humanas e sociais. Os autores recomendam a realização de estudos do conceito na perspectiva das pessoas e que os comitês de ética avaliem o consentimento informado e as orientações de acordo com esses resultados. As categorias permitem formular o conceito de vulnerabilidades, o qual, na bioética, deve ser analisado para além do principialismo.

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          Social Vulnerability and Racial Inequality in COVID-19 Deaths in Chicago

          Although the current COVID-19 crisis is felt globally, at the local level, COVID-19 has disproportionately affected poor, highly segregated African American communities in Chicago. To understand the emerging pattern of racial inequality in the effects of COVID-19, we examined the relative burden of social vulnerability and health risk factors. We found significant spatial clusters of social vulnerability and risk factors, both of which are significantly associated with the increased COVID-19-related death rate. We also found that a higher percentage of African Americans was associated with increased levels of social vulnerability and risk factors. In addition, the proportion of African American residents has an independent effect on the COVID-19 death rate. We argue that existing inequity is often highlighted in emergency conditions. The disproportionate effects of COVID-19 in African American communities are a reflection of racial inequality and social exclusion that existed before the COVID-19 crisis.
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            Structural vulnerability and health: Latino migrant laborers in the United States.

            Latino immigrants in the United States constitute a paradigmatic case of a population group subject to structural violence. Their subordinated location in the global economy and their culturally depreciated status in the United States are exacerbated by legal persecution. Medical Anthropology, Volume 30, Numbers 4 and 5, include a series of ethnographic analyses of the processes that render undocumented Latino immigrants structurally vulnerable to ill health. We hope to extend the social science concept of "structural vulnerability" to make it a useful concept for health care. Defined as a positionality that imposes physical/emotional suffering on specific population groups and individuals in patterned ways, structural vulnerability is a product of class-based economic exploitation and cultural, gender/sexual, and racialized discrimination, as well as complementary processes of depreciated subjectivity formation. A good-enough medicalized recognition of the condition of structural vulnerability offers a tool for developing practical therapeutic resources. It also facilitates political alternatives to the punitive neoliberal policies and discourses of individual unworthiness that have become increasingly dominant in the United States since the 1980s. Copyright © 2011 Taylor & Francis Group, LLC
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              Syndemic vulnerability and the right to health.

              Investigators working both in syndemics, a field of applied health research with roots in medical anthropology, and in the field of health and human rights recognise that upstream social, political, and structural determinants contribute more to health inequities than do biological factors or personal choices. Syndemics investigates synergistic, often deleterious interactions among comorbid health conditions, especially under circumstances of structural and political adversity. Health and human rights research draws on international law to argue that all people deserve access not only to health care, but also to the underlying determinants of good health. Taking the urgent matter of migrant health as an empirical focus, we juxtapose the fields of syndemics and health and human rights, identify their complementarities, and advocate for a combined approach. By melding insights from these fields, the combined syndemics/health and human rights approach advanced here can provide clinicians and other key stakeholders with concrete insights, tools, and strategies to tackle the health inequities that affect migrants and other vulnerable groups by: (1) mapping the effect of social, political, and structural determinants on health; (2) identifying opportunities for upstream intervention; and (3) working collaboratively to tackle the structures, institutions, and processes that cause and exacerbate health inequities. Undergirding this approach is an egalitarian interpretation of the right to health that differs from narrow legalistic and individual interpretations by insisting that all people are equal in worth and, as a result, equally deserving of protection from syndemic vulnerability.
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                Author and article information

                Journal
                pebi
                Persona y Bioética
                pers.bioét.
                Universidad de la Sabana (Chia, Cundinamarca, Colombia )
                0123-3122
                2027-5382
                December 2021
                : 25
                : 2
                : e2522
                Affiliations
                [1] Valle del Cauca orgnameUniversidad del Cauca Colombia adrianitalvf@ 123456unicauca.edu.co
                [4] Los Lagos orgnameUniversidad de Los Lagos Chile claudio.mancilla2@ 123456ulagos.cl
                [2] Los Lagos orgnameUniversidad de Los Lagos Chile carlosalberto.fernandez@ 123456ulagos.cl
                [3] Los Lagos orgnameUniversidad de Los Lagos Chile carla.bittner@ 123456ulagos.cl
                Article
                S0123-31222021000202522 S0123-3122(21)02500202522
                10.5294/pebi.2021.25.2.2
                986bf7f3-9cea-42fa-b571-3c4ed7635986

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 30 June 2021
                : 15 September 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 66, Pages: 0
                Product

                SciELO Colombia

                Categories
                Artículos de reflexión

                Bioethics,populações vulneráveis,vulnerabilidade em saúde,vulnerabilidade a desastres,vulnerabilidade social,análise de vulnerabilidade,Bioética,vulnerable Populations,health vulnerability,disaster vulnerability,social vulnerability,vulnerability analysis,poblaciones vulnerables,vulnerabilidad en salud,vulnerabilidad en desastres,vulnerabilidad social,análisis de vulnerabilidad,bioética

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