Using an ethical approach to the study of employability, we question the mainstream approach to career self-direction. We focus on a specific category of employees that has been neglected in past research, namely vulnerable workers who have been unemployed for several years and who have faced multiple psychosocial problems. Building on the Ability-Motivation-Opportunity model, we examine how establishing clear expectations, developmental inducements, and social organizational goals can foster employability competences of vulnerable workers. Our study took place (...) in the particularly relevant context of social enterprises, which have a primary goal to enhance the employability competences of vulnerable workers. Multilevel analysis of data from 38 CEOs of social enterprises, 121 leaders and 594 workers, demonstrated that establishing clear expectations and developmental inducements enable vulnerable workers to anticipate and optimize their employability competences. Furthermore, a positive association was found between establishing clear expectations and the balance dimension of employability, yet only in social enterprises that prioritize social organizational goals, suggesting the need to recognize the extent organizational goals shape opportunities for vulnerable workers. Establishing clear expectations and developmental inducements can therefore enhance vulnerable workers’ employability competences in supportive contexts; however, there may be detrimental side effects to drifting away from social organizational goals. (shrink)

In recent years, the decent work agenda has called upon vocational psychologists to advance psychological research and intervention to promote work as a human right. Furthermore, the COVID-19 pandemic is having disproportionate consequences on vulnerable workers, such as unemployment and underemployment, highlighting the need to enhance access to decent work for these workers. As a response, the present perspective article advances job crafting as a promising way to shape decent work for marginalized workers. To this end, (...) the article deals with decent work and job crafting, starting with the definition of decent work according to the psychology of working theory and examining the evolution of the construct of job crafting. Subsequently, the literature on job crafting is discussed, focusing on variables related to the PWT model of decent work and their effect on vulnerable workers. Finally, possibilities for further research and intervention aimed at promoting decent work through job crafting are discussed. (shrink)

There is a consensus that the effects of medical brain drain, especially in the Sub-Saharan African countries, ought to be perceived as more than a simple misfortune. Temporary restrictions on the emigration of health workers from the region is one of the already existing policy measures to tackle the issue—while such a restrictive measure brings about the need for quite a justificatory work. A recent normative contribution to the debate by Gillian Brock provides a fruitful starting point. In the (...) first step of her defence of emigration restrictions, Brock provides three reasons why skilled workers themselves would hold responsibilities to assist with respect to vital needs of their compatriots. These are fair reciprocity, duty to support vital institutions, and attending to the unintended harmful consequences of one’s actions. While the first two are explained and also largely discussed in the literature, the third requires an explication on how and on which basis skilled workers would have a responsibility as such. In this article, I offer a vulnerability approach with its dependency aspect that may account for why the health workers in underserved contexts would have a responsibility to attend to the unintended side effects of their actions that may lead to a vital risk of harm for the population. I discuss HIV/AIDS care in Zimbabwe as a case in point in order to show that local health workers may have responsibilities to assist the population who are vulnerable to their mobility. (shrink)

Researchers from the Universities of Oxford, Nairobi, and Manitoba are collaborating on a project to develop an HIV vaccine based on the immunological protection mechanisms found in commercial sex workers from the Majengo slum in Nairobi. This group consists of educationally and economically disadvantaged women who resort to commercial sex work for a living. A clinic was established in the slum to study sexually transmitted diseases, which now includes HIV/AIDS. The clinic serves as a research facility for the collaborating (...) researchers who have been using the women's blood, cervical, vaginal, and saliva samples for the ongoing studies. The clinic runs two HIV-integrated activities: HIV research and HIV care and treatment. For HIV negative participants, samples are collected and used for research and care after they give informed consent. (shrink)

We examine the short-term and long-term impact of bilateral agreements on migrant workers’ vulnerability during their employment in Israel. To do so, we developed the Vulnerability Index of Migrant Workers based on five dimensions: poor working conditions, poor living conditions, poor safety conditions, low wages, and dependence on migration costs. We focus on migrant workers arriving in Israel from two different countries, employed in two different sectors of the economy. Data was gathered through a survey conducted among (...) workers arriving from both countries before and after the implementation of the bilateral agreements. The study revealed that after the implementation of bilateral agreements, the working, living and safety conditions of migrant workers remained poor or even worsened. For Thai workers, there was a slight improvement in the working and living conditions in the short term after the bilateral agreement, but they worsened in the long run. The total Index of Vulnerability of both groups showed improvement due to the dramatic decrease in dependence on migration costs, despite the deterioration in some working and living conditions and the reduction in migrant workers’ relative wages. (shrink)

?Vulnerability? is now a popular term in the lexicon of every-day life and a notion frequently drawn upon by policy-makers, academics, journalists, welfare workers and local authorities. This essay explores some of the ethical and practical implications of ?vulnerability? as a concept in social welfare. It highlights how ideas about vulnerability shape the ways in which we manage and classify people, justify state intervention in citizens? lives, allocate resources in society and define our social obligations. The lack of clarity (...) and limited analysis of the concept of ?vulnerability? in welfare arenas is highlighted as concerning, particularly given that those seen as most in need of support seem to be implicated in commonly held views about ?the vulnerable?. I argue that far from being innocuous, ?vulnerability? is so loaded with political, moral and practical implications that it is potentially damaging to the pursuit of social justice. Two opposing presentations of the notion are set out in order to illustrate that ?vulnerability? is a concept that should be handled with more care. (shrink)

Intimate relationships such as love and friendship involve familiar patterns of vulnerability. Loving someone renders one susceptible to distress and sorrow when the beloved is harmed and when the loving relationship is impaired. The distinctive kind of vulnerability bound up with intimate relationships also presents an opportunity for wrongful exploitation: for one participant to unfairly use, take advantage of, the other. In the case of commercial exploitation (e.g., exploitation of sweatshop workers), the remedy typically involves either preventing those in (...) the relevant positions of power from taking advantage of the vulnerability of the powerless or removing the vulnerabilities of those in the relevant positions of powerlessness. I argue there are there limits to the application of these two strategies in the intimate relationship context, and I consider what (if anything) might guard against the possibility of exploitation in intimate relationships. (shrink)

Legislation for dementia care needs to be continually rethought, if the rights of older persons and other persons with dementia are to be addressed properly. We propose a theoretical framework for understanding vulnerability and dependency, which enables us to problematize the currently prevailing legal conception of adults as always able — irrespective of health or age — to act autonomously in their everyday lives. Such an approach gives rise to difficult dilemmas when persons with dementia are forced to make decisions (...) on their own about basic living conditions, such as housing and care, without decision-making support. In Sweden, for example, such matters are frequently left to the person him- or herself to decide, often without any assistance from social workers, and with family members serving as caregivers of last resort.Using vulnerability theory as the framework for our discussion, we argue that policymakers should not apply a group-oriented approach (based on factors like age, legal status, or mental capacity) to persons suffering from dementia. The needs of such individuals are as complex and varied as they themselves are. We discuss our findings from an interdisciplinary (law/social work) research project in which we examine the dilemma that social workers face when they are required, under the terms of the Swedish Social Services Act, to determine whether persons with dementia are to be granted support.We argue further that a cross-disciplinary approach — in which vulnerability theory furnishes the framework — opens up for new ways of understanding and developing social welfare law and practice. This, we believe, can help us better address the rights, interests, and needs of people with dementia, of their families, and of professionals in the social welfare system. Finally, many of the problems faced by ageing societies in general can be understood on the basis of such an approach. (shrink)

This article analyses MNCs, worker identity and the ethical vulnerability caused by over-reliance on expatriate managers and under-reliance on local managers, who are often undervalued. It is argued that MNCs not only need but also have an obligation to assess local managers’ knowledge and contributions as having not only operational and market values, but also institutional value. Local managers both give access to and form part of local social capital and the treatment they receive is an element in the CSR (...) performance of the MNCs. Recognition of the value of equal treatment creates an ethical imperative that the barriers of cultural difference be overcome. We see such an approach towards local managers as more fully taking into account the human rights of these local managers. Such a holistic approach is increasingly relevant for MNCs in the 21st century, as MNCs increasing globalize into new large emerging markets such as Brazil, Russia, India and China. (shrink)

Much of the debate around temporary foreign worker programs in recent years has focused on full or partial access to rights, and, in particular, on the extent to which liberal democratic states may be justified in restricting rights of membership to those who come and work on their territory. Many accounts of the situation of temporary foreign workers assume that a full set of rights will remedy moral inequities that they suffer in their new homes. I aim to show (...) two things: first, and based on experiences reported by former Live-in-Caregivers in Canada who now have access to the full set of citizenship rights, and German citizens who are descendants of Kurdish guestworkers in Germany, I have proposed that even after gaining citizenship, many of them experience social stigma and a sense of exclusion. Second, I have argued that this neglects a basic need that individuals have, which is to have access to relational resources within society in order to be protected against social deprivation. This need is seemingly immune to be effectively protected through the known catalogue of social, civic and political rights. Instead, I argue that social deprivation needs to be analyzed through the lens of institutional vulnerability to yield an analysis of the moral obligations of liberal democratic states. (shrink)

Introduction: Agricultural workers perform intense labor outside in direct sunlight and in humid environmental conditions exposing them to a high risk of heat-related illness (HRI). To implement effective cooling interventions in occupational settings, it is important to consider workers’ perceptions. To date, an analysis of agricultural workers’ experience and perception of cooling devices used in the field while working has not been published. -/- Methods: Qualitatively data from 61 agricultural workers provided details of their perceptions and (...) experiences with cooling interventions. -/- Results: The participants in the bandana group reported the bandana was practical to use at work and did not interfere with their work routine. Cooling vest group participants agreed that the vest was effective at cooling them, but the practicality of using the vest at work was met with mixed reviews. -/- Conclusion: The findings of this qualitative study support and extend existing research regarding personal cooling and heat prevention research interventions with vulnerable occupational groups. Personal cooling gear was well received and utilized by the agricultural workers. Sustainable heat prevention studies and governmental protection strategies for occupational heat stress are urgently needed to reduce the risk of heat-related morbidity, mortality, and projected climate change health impacts on outdoor workers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.4 (2004) 411-425 [Access article in PDF] Vulnerability, Vulnerable Populations, and Policy Mary C. Ruof "Special justification is required for inviting vulnerable individuals to serve as research subjects and, if they are selected, the means of protecting their rights and welfare must be strictly applied."Guideline 13: Research Involving Vulnerable Persons International Ethical Guidelines for Biomedical Research Involving Human Subjects Council for (...) International Organizations of Medical Sciences (CIOMS) and World Health Organization (WHO) Geneva, Switzerland, 2002 Within medical research and healthcare certain groups are afforded special protections and services because of their designation as vulnerable. The vulnerable require special justification to participate in human subject research in order to eliminate potential human rights abuses. The Nuremberg Code of 1947 was written in response to the extreme human subject abuses that occurred under the Nazi regime, and, although the intent of the 1947 Code was to protect human rights, rigid voluntary consent requirements deprived some individuals of the right to participate in clinical trials. Recent human research guidelines, such as the CIOMS/WHO guidelines referenced above and the guidelines referenced in Section V of this Scope Note, attempt to balance both protection from abuse in research and access to new, experimental treatments for the vulnerable.Although various protective guidelines stipulate special protections for vulnerable populations, the concept of vulnerability and consequently the criteria designating vulnerable populations remain vague. Precisely who are the vulnerable? The word "vulnerability" stems from the Latin vulnerare, "to wound." (Oxford Encyclopedic English Dictionary 1995). In clinical research, the term [End Page 411] vulnerable generally is applied to individuals who are unable to give informed consent or who are susceptible to coercion. The Common Rule (45 CFR 46, Subpart A) includes as vulnerable research subjects: children, prisoners, pregnant women, and persons who are handicapped, mentally disabled, economically disadvantaged, or educationally disadvantaged. Although the Common Rule specifies certain vulnerable categories, the guidelines were not intended to be exclusive, leaving open the interpretation of vulnerability.In medical research and health policy, vulnerability is an abstract concept that has concrete effects both for those labeled vulnerable and for those not. Clinical researchers, healthcare workers, ethical reviewers, and policymakers must be able to identify vulnerable subjects to establish how healthcare resources will be allocated and who will qualify for special protections and socialized benefits. Attempts to quantify vulnerability in clear, measurable ways have met little if any consensus. As Alexander Morawa (II, 2003, p. 150) states, "There is no single approach to definition of vulnerability. In fact, there is no purposeful categorisation at all."Difficulties in defining vulnerability have prompted discourse surrounding its utility as a qualifying factor in the allocation of health resources and its appropriateness as a guiding principle in bioethics. Some of the authors cited in this Scope Note argue against the labeling and categorization of vulnerable individuals and populations. "Labeling individuals as 'vulnerable' risks viewing vulnerable individuals as 'others' worthy of pity, a view rarely appreciated" (III, Danis and Patrick 2002, p. 320). The categories of vulnerable groups listed under the Common Rule have been the source of controversy, "for example, many find the suggestion that pregnant women are vulnerable to be quite sexist" (IV, DeBruin 2001, p. 7). Instead of creating categories of vulnerable populations, would it not be better to derive an account of just treatment from a just social policy at large that encompasses human vulnerabilities (II, Brock 2002, p. 283).For some of the authors listed here, the concept of vulnerability is essential to bioethics. Robert Goodin (I, 1985, p. 107) writes that the vulnerability of other human beings is the source of our special responsibilities to them. In contrast to the four American principles of biomedical ethics—autonomy, nonmaleficence, beneficence, and justice—the four principles of European bioethics and biolaw include vulnerability along with autonomy, dignity, and integrity. According to, Jacob Dahl Rendtorff and Peter Kemp (I, 2000, p. 274) "the principle of vulnerability is ontologically prior to the other [European] principles, it expresses better than all of the other ethical principles... the finitude of the human condition."Some of the... (shrink)

In recent years, rather than addressing the needs of sex workers themselves or of trafficked persons, international anti-trafficking law has been mobilised towards an ideological end, namely the abolition of sex work. The vulnerability of ‘third world’ female sex workers in particular has provided a potent image for justifying state intervention backed by the full force of the criminal law. Moral legitimacy has been afforded to this by a radical feminist discourse which views sex workers as nothing (...) but hapless victims. Drawing on the work of Martha Fineman and legal realists like Robert Hale, this article redeploys vulnerability in trafficking debates to depart from its narrative of victimhood and to offer a renewed critique of liberal legalism, which has in the trafficking context been characterised by legal strategies of criminalisation and the attendant rescue and rehabilitation of trafficked persons. Specifically, it examines how three Indian social legislations regulating bonded labour, contract labour and inter-state migrant labour, and targeted at the domestic trafficking of men, conceptualise vulnerability in substantially different ways when compared to the 2000 Palermo Protocol on Trafficking (at least as it has been enforced to date). To the extent that these Indian laws construe the vulnerability of labour as systemic, trafficking is understood as a problem of labour migration to be addressed primarily by labour law. As such, this view of vulnerability, I argue, not only helps to de-exceptionalise trafficking as always equivalent to the trafficking of women for sex work, and therefore sex work, but also to substantively address the vulnerability of both male and female workers in other labour markets. (shrink)

For the past two decades, agricultural workers in regions of Central America have reported an epidemic of chronic kidney disease of undetermined etiology (CKDu) that is not associated with established risk factors of chronic kidney disease. Several hypotheses have emerged, but the etiology of CKDu remains elusive and controversial. The aim of this literature review was to describe the potential risk factors of CKDu in Mesoamerica and implications for the U.S. agricultural worker population. PubMed and CINAHL databases were searched (...) for articles published between 2000 and 2018 that examined CKDu in Mesoamerica; 29 original studies were included in this review. CKDu is a multifactorial disease that is often asymptomatic with hallmark characteristics of elevated serum creatinine and blood urea nitrogen (BUN), low glomerular filtration rate, electrolyte abnormalities, and non-nephrotic proteinuria. Reducing the global prevalence of CKDu will require more robust studies on causal mechanisms and on interventions that can reduce morbidity and mortality in vulnerable populations. (shrink)

Open access. This open-access book discusses vulnerability and the protection-inclusion dilemma of including those who suffer from serious poverty, severe stigma, and structural violence in research. Co-written with representatives from indigenous peoples in South Africa and sex workers in Nairobi, the authors come down firmly on the side of inclusion. In the spirit of leaving no one behind in research, the team experimented with data collection methods that prioritize research participant needs over researcher needs. This involved foregoing the collection (...) of personal data and community researchers being involved in all stages of the research. In the process, the term ‘vulnerability’ was illuminated across significant language barriers as it was defined by indigenous peoples and sex workers themselves. The book describes a potential alternative to exclusion from research that moves away from traditional research methods. By ensuring that the research is led by vulnerable groups for vulnerable groups, it offers an approach that fosters trust and collaboration with benefits for the community researchers, the wider community as well as research academics. Those living in low-income settings, in dire situations that are summarized with the term ‘vulnerability’ know best what their problems are and which priorities they have. To exclude them from research for their own protection is a patronizing approach which insinuates that researchers and research ethics committees know best. The team from this book have shown that minimally risky and minimally burdensome research tailored towards the needs of highly marginalized and stigmatized communities can be scientifically valuable as well as inclusive and equitable. I congratulate them. Prof. Klaus Leisinger, President Global Values Alliance, Former personal advisor to Kofi Annan on corporate responsibility. (shrink)

Migrant workers in dormitories are an attractive source of clinical trial participants. However, they are a vulnerable population that has been disproportionately affected by the COVID-19 pandemic. Guidelines on recruiting vulnerable populations for clinical trials have long been established, but ethical considerations for migrant workers have been neglected. This article aims to highlight and explain what researchers recruiting migrant workers must be cognizant of, and offers recommendations to address potential concerns. The considerations raised in this (...) article include: three types of illiteracy, power dynamics, the risks associated with communal living and potential benefits to the migrant workers as well as researchers. No data are available. This article does not include original data. (shrink)

Business Ethics, the Environment &Responsibility, Volume 31, Issue 4, Page 969-980, October 2022.

Plantation workers have seemingly little opportunities for labour agency, defined as the worker’s ability to act and improve their conditions. In response to a call for a better understanding of the horizontal dimension shaping labour agency, this article questions what local factors determine the worker’s ability to act by analysing the institutional constraints embedded in the national context through a mixed methods approach. A combination of qualitative and quantitative data is used to understand what shapes and constrains the potential (...) for labour agency in the case of plantation workers in the pineapple sector of Costa Rica. We provide new empirical evidence of the relation between the local opportunity structure—proxied by perceived job security and union awareness—and labour agency in terms of a worker’s intention to choose forthright (voice), evasive (exit) or repressed (loyalty) actions. The model results indicate that a lack of job security and a lack of union awareness significantly reduce the likelihood to use forthright actions (such as voicing concerns, striking or joining a union) compared to evasive (such as leaving the job) or repressed actions (such as doing nothing). In addition, the qualitative analysis of the local opportunity structure identifies four institutional constraints: weak employment protection, vulnerability of migrant workers, limited workers’ representation and insufficient labour law enforcement. Besides overcoming these institutional constraints, empowering workers to make their voices heard also requires awareness raising about their collective bargaining rights and more job security. (shrink)

Paid care services such as child care, elder care, teaching, and nursing are vulnerable to competitive pressures that often generate low-pay/low-quality outcomes. Both workers and consumers suffer as a result. This article develops an economic analysis of the “care sector” that emphasizes the potential to build political coalitions that could push for a high-pay/high-quality alternative.

The main purpose of our paper consists in establishing the idea that the negative consequences that result from child poverty can be mitigated if the government and social workers promote the resilience of poor children. We use Amartya Sen’s capability approach as an evaluative framework to argue for this thesis. By distinguishing different sources of vulnerability we assume that children are inherently vulnerable, because they are dependent and in need of care. Poor children are, however, even more (...) class='Hi'>vulnerable in specific ways. Following Catriona Mackenzie, we call these vulnerability “pathogenic”; they are caused by social arrangements like institutional settings. We claim that at least some of those vulnerabilities can and should be diminished by promoting children’s resilience. We proceed in three steps. In the first part of the paper, we develop our concept of vulnerability and explain how child poverty renders children vulnerable to specific harms. Here we also introduce the capability approach by asking which capabilities children need for coping with this situation. In part two we argue that the concept of resilience helps us to understand why capabilities are relevant for coping with the adverse effects of child poverty. We claim that promoting the capabilities of children is a matter of justice, and that implementing resilience is, too. It is also highly important to see that promoting resilience is mainly a social matter, not a task the individual child has to fulfil on its own. Hence, we argue that children are entitled to gain those capabilities that promote their resilience against the adverse effects of poverty. In part three we discuss several difficulties of our account, such as the danger that children will be burdened with coping with the effects of poverty instead of society fighting poverty. (shrink)

A key challenge in conducting paid internet-based studies is that individuals may feign eligibility to participate. This case series describes three examples where people attempted to fake being locals with health vulnerabilities to participate in paid internet-mediated studies. In two cases, individuals pretended to have serious cancer diagnoses to participate in a randomized controlled trial. In the third case, an individual pretended to be nine restaurant workers at high risk of occupational COVID-19 exposure to participate in an online survey. (...) Key red flags among individuals feigning eligibility are noted. Ethical and practical methodologic implications are discussed. (shrink)

Bribing doctors for preferential treatment is rampant in the healthcare system of developing countries like Vietnam. Although bribery raises the out-of-pocket expenditures of patients, it is so common to be deemed an “envelope culture.” Given the little understanding of the underlying mechanism of the culture, this study employed the mindsponge theory for reasoning the mental processes of both patients and doctors for why they embrace the “envelope culture” and used the Bayesian Mindsponge Framework (BMF) analytics to validate our reasoning. Analyzing (...) responses from 1042 Vietnamese patients, we discovered that bribing doctors can help patients reduce the destitution risk induced by treatment. Such effect of doctor bribery remains consistent among patients that have to pay high daily costs (e.g., accommodation and subsistence fees) regardless of their employment status. Nevertheless, for patients with no or unstable jobs, their risks of destitution increase if they have to pay more thank-you money. These findings suggest that doctor bribery is an adaptive strategy for patients in an environment where the healthcare supply cannot meet the actual demand. Moreover, healthcare equity is greatly exacerbated due to the envelope culture, as vulnerable individuals are exposed to a greater threat of poverty. At the same time, those with good economic conditions get preferential treatment by paying a higher amount of thank-you money. Healthcare workers’ ethics must be the top priority for an equitable and proper healthcare system. (shrink)

Sex workers in the Netherlands experienced severe financial and social distress during the COVID-19 health crisis. Notwithstanding them paying taxes over the earnings, they were excluded from government financial support, faced discriminatory treatment concerning safe reopening, and experienced increased repression and stigmatization. In this contribution, I explore whether the concept of “vulnerability” contributes to understanding (and addressing) that situation. Data acquired through participatory action research, partly taking place online during lock-down measures, and literature and content analysis show that labeling (...) sex workers “vulnerable” deflects attention away from the (in)actions of Dutch authorities responsible for sex workers’ precarious conditions during the pandemic. Government denial and strategies of abjection explain these conditions better than “vulnerability” does, as they return the gaze to actors and processes accountable for sex workers’ exclusion and criminalization during the COVID-19 health crisis and thereby put responsibility where it belongs. (shrink)

In this paper, we explore the experiences of EU migrants working in UK restaurants in the aftermath of the Brexit vote. We do so through a care ethics lens, which we bring together with the integrative approach to organisational silence to consider the ethical consequences of the organisational policies of political silence adopted by the restaurant chains in our qualitative empirical study. We develop the concept of political organisational silence and probe its ethical dimensions, showing how at the organisational level (...) it falls short of constituting a practice of caring for migrant workers in politically divisive and hostile times. We argue that organisational policies of political silence emphasise the exploitative nature of the business of (im)migration, which prioritises concern for profits over care for the needs of others. Organisations refuse caring responsibility for migrant workers, leaving care to the migrants themselves and their co-workers and managers. Whilst peer-care practices partially fill this politically silent care-vacuum, this leaves individuals to negotiate difficult tensions without institutional support at a time of increased uncertainty, complexity, hostility, violence, and vulnerability. Drawing lessons from our study and its aftermath, we call for a care manifesto to inform the business of (im)migration, which would need to include caring political responsibility towards migrant workers exercised through caring political organisational voice as well as silence. (shrink)

In recent years, the concept of vulnerability has emerged in bioethics eroding the primacy of the autonomous and self-sufficient individual of the mainstream approach, regarding vulnerability as an obstacle to be removed. The Covid-19 pandemic has underscored an awareness that is not new, yet often little considered, namely that vulnerability is both a universal condition, and a special state dependent on social and economic causes, making the traditional concept of health inadequate to provide answers in the healthcare field. The aim (...) of the work is to examine how the pandemic has challenged the well-being conception of health, and the impact on healthcare and healthcare workers of a definition of health based on vulnerability. Indeed, the connection between health and vulnerability has some practical implications. Particularly, it can shift the focus to vulnerability of healthcare professionals, who have always been considered almost immune from it with the effect of obscuring the dimension of reciprocity between the patient and the physician. The Covid-19 pandemic has made a contribution in the process already began of rethinking health in the light of vulnerability, by bringing out the notion of relational health, and stressing the need to educate to a new approach, in order to increase the wellbeing of all subjects involved in the caring relationship. (shrink)

The U.S. agricultural sector relies heavily on agricultural migrant workers, and Florida has a history of (im)migrant labor. However, this system is historically rooted in colonization, and its systems of oppression remain. Currently, migrant workers operate in various systems of oppression, including social, health, and environmental inequities, all of which have been worsened by the COVID-19 pandemic. The literature regarding decoloniality, muted group theory, and decolonial intersectionality has a strong history of uncovering how multiple oppressions overlap for (...) class='Hi'>vulnerable and marginalized groups in the US. We draw on this literature to ask: 1) how can examining participants’ stories through decolonial intersectionality help explore structural and institutional racism and the dominance of muting? and 2) how can participants recount how they resist oppression and/or unmute in telling their stories? To answer these questions, literary portraits were co-created with farmworkers and community liaisons about participants’ experiences. The authors used decoloniality, muted group theory, and decolonial intersectionality to analyze participants’ creative non-fiction stories. Farmworkers recounted through their stories that they were often devalued, had their humanity questioned, and negotiated their survival, especially during COVID-19. However, they were able to resist the oppressions of coloniality through their families, faith, pride, and love. Recommendations include using storytelling techniques to align with farmworkers’ wants in research as well as assist in communicating about issues regarding health and safety. Non-profit organizations, centers of faith, and universities can assist in serving the needs of agricultural migrant workers related to childcare, food security, and worksite and home safety issues. (shrink)

This doctoral thesis within applied ethics consists of four articles together with a cover essay. All articles concern the ethics of skilled health worker emigration from under-served and resourcepoor regions, often referred to as ‘medical brain drain’. Methodologically, the thesis utilizes normative ethical theory to analyse the justifiability of temporary or long-term emigration restrictions, such as compulsory health service programmes, that are employed by developing countries with the aim of safeguarding their needs for health care provision. Such programmes restrict the (...) mobility of individual health workers and give rise to conflicts between different types of rights and interests. -/- The ethics of skilled worker emigration warrants an exploration of the ethical implications of such restrictive programmes for different stakeholders, such as the under-served countries and health workers; and a clarification of the rights and duties of the concerned parties. This thesis provides a thorough analysis and clarification of such rights restrictions and offers theoretically and empirically grounded recommendations as to how they ought to be managed. Rights theory and accounts of individual responsibilities are employed to assess the acceptability of restrictive health service programmes. -/- In brief, the thesis (a) discusses the conditions under which individual health workers may have responsibilities to attend to the basic health needs of a population, (b) explicates the rights at stake such as the freedom of movement and the right to exit, (c) offers insight into what it means to restrict one’s right and its implications and (d) suggests ways for conflicting rights and interests to be balanced and resolved. Taken together, the thesis presents a nuanced approach towards individual responsibilities in under-served contexts and an improved understanding of the right to exit as well as the implications of restricting the right. The thesis also contributes to the ethics of skilled worker emigration with a discussion on the responsibilities of skilled workers when the other parties do not fulfil their fair share of responsibilities. (shrink)

Over recent decades, developments in network governance have seen governments around the world cede considerable authority and responsibility to commercial migration intermediaries for recruiting and managing temporary migrant labour. Correspondingly, a by-product of network governance has been the emergence of soft employment regulation in which voluntary codes of conduct supplement hard legal employment standards. This paper explores these developments in the context of temporary migrant workers employed in Australian horticulture. First the paper analyses the growing use of temporary migrant (...) labour in this industry. It then describes how different types of intermediaries interact with this workforce. The paper then outlines both hard and soft employment regulations, and contrasts them with actual employment conditions, questioning how a network governance approach has affected this vulnerable workforce. The paper concludes that changes in network governance of migration and employment relations have emasculated formal legal regulation, leaving market forces to operate without effective or ethical constraints at the expense of the public good. (shrink)

Context: Comparing the Covid-19 related experiences of vulnerable groups can help to improve public health.?The United States and the United Kingdom are both characterized by underfunded public health in the context of racist systems. We reviewed differences in Covid-19 outcomes between groups in the US and UK and compared intergroup differences between the two countries. Methods: The scoping review analyzed articles published in English during the Covid-19 pandemic focusing on the US or the UK. Using Scopus and PubMed, research (...) articles were chosen based on titles, abstracts, and relevance to the research question. Certain demographic groups known to be differentially affected by Covid-19 were chosen a priori for inclusion. Data was extracted by the first author and reviewed by senior authors. 63 studies met the inclusion criteria. Results: Two studies compared the US and UK. One found that minority status is an important social determinant of health (SDOH) of Covid-19 related health outcomes in both countries, likely through association with other SDOH. Another found that the risk of confirmed infection was higher in African-Americans, Hispanic Americans, and Asian Americans in the US and in African-Caribbean/Black-Africans, South-Asians, and Mixed-race people in the UK, compared with their respective White peers. Asian ethnicity is subject to different definitions in the US and the UK. Individual articles focusing on either the US or the UK also found that, in both countries, essential workers were impacted; those with disabilities were more often affected by Covid-19 related comorbidities in both countries. In addition, in both the US and the UK, people living in multigenerational families were more susceptible to Covid-19. Misclassification of causes of morbidity and mortality was noted in both countries. Discussion and conclusion: A limited literature indicates that, in both the US and UK, non-White populations were more affected by the Covid-19 pandemic, possibly due to association of SDOH with racist systems. Racial definitions differ between these countries and this needs further research. In both countries, data focused on LGBTQ+ groups and people with disabilities is lacking. (shrink)

Over recent decades, developments in network governance have seen governments around the world cede considerable authority and responsibility to commercial migration intermediaries for recruiting and managing temporary migrant labour. Correspondingly, a by-product of network governance has been the emergence of soft employment regulation in which voluntary codes of conduct supplement hard legal employment standards. This paper explores these developments in the context of temporary migrant workers employed in Australian horticulture. First the paper analyses the growing use of temporary migrant (...) labour in this industry. It then describes how different types of intermediaries interact with this workforce. The paper then outlines both hard and soft employment regulations, and contrasts them with actual employment conditions, questioning how a network governance approach has affected this vulnerable workforce. The paper concludes that changes in network governance of migration and employment relations have emasculated formal legal regulation, leaving market forces to operate without effective or ethical constraints at the expense of the public good. (shrink)

Duty of care is the core ethical responsibility of healthcare workers. Getting the workforce vaccinated will provide safety to the public, protect the vulnerable population and provide a safe working environment. While most agree that healthcare workers should be prioritised in the vaccination programme, mandatory vaccination remains a complicated and contentious issue with political, legal and ethical dimensions. This study aims to determine the ethical considerations associated with mandatory vaccinations among healthcare workers. A total of 152 (...) abstracts were identified of which, 142 were excluded based on abstracts because they did not meet the inclusion criteria. The remaining ten articles were further evaluated with three articles that fit the inclusion criteria specifically discussing mandatory vaccination among healthcare workers and the ethical issues. Benefits, risks, effectiveness, equity and justice, autonomy, reciprocity and trust were used as a framework to discuss the ethical considerations which resonated both directly from the included papers, as well as more generally from the other literature associated with this search. There is limited literature on the topic of ethical considerations associated with COVID-19 mandatory vaccination of healthcare workers, as a systematic review identified only 3 papers. Benefits, risks, effectiveness, equity and justice, autonomy, reciprocity and trust were among the seven ethical considerations identified and discussed. (shrink)

BackgroundPsychological support was provided by the Eye Movement Desensitization and Reprocessing Integrative Group Treatment Protocol within the hospitals in the Northern Italy in favor of healthcare workers during the COVID-19 pandemic. This study aimed at evaluating the effectiveness of treatment in terms of symptomatology reduction related to peri- and post-traumatic stress; clinical improvement over time; and the maintenance of the achieved outcome over time.MethodsThe population was composed of healthcare workers who spontaneously requested psychological intervention in both the first (...) and the second emergency waves. Statistical analyses were carried out to highlight the differences in Impact of Event-Revised and Post-Traumatic Growth Inventory before and after the group intervention.ResultsIn both the first and the second waves, pre-treatment values are higher than post-treatment values for all dimensions of the IES-R. The results show that there are no significant differences between the first and the second wave with regard to the treatment effect. Healthcare workers maintained positive changes over time despite their prolonged exposure to an emergency and the possibility of retraumatization at the onset of a new emergency phase, irrespective of their working place. Healthcare workers who were treated in the first wave showed at the beginning of the second emergency wave less vulnerability and more resilience than those who were treated only in the second wave.Pre-treatment scores of healthcare workers affected by COVID-19 are discussed.ConclusionCOVID-19 had a significant impact on the well-being of healthcare workers who were working in hospitals. Psychological support in case of emergency is needed. (shrink)

The impact of COVID-19 on chronic pain in non-infected vulnerable South American subjects is unknown. Healthcare workers are at increased risk for CP. During the pandemic, many HCWs with CP kept working. Knowing how cognition is affected by CP in these subjects is an important subject for work safety. The attention domain has a pivotal role in cognition. Previously, the Continuous Visual Attention Test was applied to detect specific attention deficits in fibromyalgia patients. The present investigation described CP (...) prevalence in non-infected Brazilian HCWs during the pandemic and assessed HCWs’ attentional performance with the aid of the CVAT. This study was carried out at a reference University Hospital in Rio de Janeiro, Brazil. HCWs of both sexes, aged 20 or older, were interviewed from August to December 2020. A 90-second version of the CVAT was performed. The average reaction time to correct responses and the respective intraindividual reaction time variability for correct responses to target was determined. Omission and commission errors were also calculated. Then, for each participant we calculated the Z-scores of the CVAT variables based on the distribution of CVAT performance of 211 healthy subjects. HCWs with Z-scores > 1.64 were classified as significantly impaired. From the 154 selected HCWs, 72 reported CP during the pandemic. Post hoc ANCOVAs showed that the average correct VRT was significantly higher in the CP group than in the non-CP group. The percentage of participants with impaired VRT performance was 30% in the CP group and 16% in the non-CP group. The difference between these two propositions reached significance. As VRT is associated with the sustained-attention subdomain, our data suggest that this subdomain is disrupted in the CP group. (shrink)

The illegal migration of Basotho women to South Africa in order to render domestic service is alarming because they are subjected to harsh treatment. This is a pastoral and theological concern for the church. As migrants, their struggle begins from the household circumstances that often force them to leave and seek job opportunities undocumented or without following prescribed migration procedures. They are then subjected to migration processes and procedures: for example, corruption and bribery by migration officers and illegal dealers. The (...) working and living conditions in South Africa are often unconducive for illegal migrants. As economic and illegal migrants, they are often considered as lesser by prejudiced employers who treat them inhumanely. Accessing essential services also imposes a significant threat to their lives.Contribution: Through this study, the article will reveal the vulnerability faced by illegal migrant Basotho women as domestic workers in South Africa. (shrink)

Burnout, characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, is an occupational phenomenon now recognized by the World Health Organization. This study explores the interplay between psychological capital and emotional labour in contributing to burnout among workers in a Malaysian non-profit organization (NPO). Psychological capital encompasses positive psychological states such as self-efficacy, optimism, hope, and resilience. Emotional labour involves managing emotions to fulfil job roles, often requiring workers to present emotions that may not reflect (...) their true feelings. The constant need to maintain these emotional displays can lead to emotional dissonance and burnout. Given Malaysia's demographic shifts towards an ageing population, the implications of burnout among NPO workers, who provide critical services to vulnerable groups, are significant. The high workload and emotional demands placed on these workers can result in chronic stress, emotional exhaustion, and a decrease in job performance and motivation. This study aims to fill the research gap by examining the specific factors that contribute to burnout in the Malaysian context, considering the unique cultural and social dynamics that may influence these relationships. The findings of this research can provide valuable insights for developing interventions to enhance psychological resilience and manage emotional labour more effectively among NPO workers. By addressing these challenges, organizations can support their workforce in maintaining high levels of service quality and personal well-being, which is crucial for the sustainability of NPOs and the well-being of the communities they serve. (shrink)

Healthcare workers are at a high risk of psychological morbidity in the face of the COVID-19 pandemic. However, there is significant variability in the impact of this crisis on individual healthcare workers, which can be best explained through an appreciation of the construct of resilience. Broadly speaking, resilience refers to the ability to successfully adapt to stressful or traumatic events, and thus plays a key role in determining mental health outcomes following exposure to such events. A proper understanding (...) of resilience is vital in enabling a shift from a reactive to a proactive approach for protecting and promoting the mental well-being of healthcare workers. Research in the past decade has identified six areas that provide promising leads in understanding the biological basis of individual variations in resilience. These are: the key role played by the monoamines noradrenaline and serotonin, the centrality of the hypothalamic-pituitary-adrenal axis in influencing stress vulnerability and resilience, the intimate links between the immune system and stress sensitivity, the role of epigenetic modulation of gene expression in influencing the stress response, the role played by certain neuropeptides as a natural “brake” mechanism in the face of stress, and the neurobiological mechanisms by which environmental factors, such as exercise, diet, and social support, influence resilience to subsequent life events. Though much of this research is still in its early stages, it has already provided valuable information on which strategies – including dietary changes, lifestyle modification, environmental modification, psychosocial interventions, and even pharmacological treatments – may prove to be useful in fostering resilience in individuals and groups. This paper examines the above evidence more closely, with a specific focus on the challenges faced by healthcare workers during the COVID-19 pandemic, and provides suggestions regarding how it may be translated into real-world interventions, as well as how the more tentative hypotheses advanced in this field may be tested during this critical period. (shrink)

Sex work or prostitution marks a controversial topic for Protestant sexual ethics. It is also a multifaceted phenomenon because it can occur in very different forms: the spectrum ranges from poverty, emergency and procurement prostitution to the self-determined and insured sex worker with all imaginable shades in between. In the current economic system, goods and services are exchanged, traded, sold, acquired and paid for, so sex work can also be understood as work. For the purposes of this article, we will (...) therefore start from an understanding of sex work as care work. Care work can be understood as the satisfaction of needs and interests of third parties and the self. If sex work is discussed as care work, this has a variety of consequences. These include the fact that questions of vulnerability and integrity come to the fore. Integrity can be comprehended as self-realisation or autonomy and thus as potentially vulnerable, taking up Axel Honneth’s early reflections on the issue of recognition. Integrity in Axel Honneth’s sense can - according to a first approximation - play a role for sex work on three levels: physical or corporeal level, structural level and lifestyle or way of life level. Finally, the essay discusses the concept of negotiated or consensual morality as a contribution of Protestant ethics. (shrink)

The EU's Farm to Fork strategy (European Commission European Commission. 2020. Farm to Fork strategy. https://food.ec.europa.eu/horizontal-topics/farm-fork-strategy_en. Accessed 31 August 2023.) highlights the need for a resilient food system capable of providing affordable food to citizens in all circumstances. Behind the provision of affordable food for EU citizens there is the effort of many migrant and seasonal food workers (MSFWs). In Almería, Spain, the area with the biggest concentration of greenhouses in the world, MSFWs face vulnerability in the form of (...) physical and institutional invisibility despite performing the essential task of providing affordable food for the EU’s food system. This paper aims to move on from structuralist concerns and place MSFWs’ lived experiences at the center, including the (in)formal nature of their food practices, to understand how the people that feed Europe feed themselves. A combination of social practice theories and diverse economies is used to explore MFSWs’ daily food routines. These theories are used as lenses that inform the data collection process, performed through semi-structured interviews, photography, and observations. The findings of the study reflect a dynamic portfolio of (in)formal practices that evolve based on the length of stay in the county. These practices demonstrate how the EU food system resilience relies on the diverse economies of migrant settlements. We conclude that informality is a reality in the EU food system, and that shedding light on previously hidden food practices and their structures can help us envision food security interventions that are inclusive for all actors involved. (shrink)

This paper examines the ethical issues of the inclusion of workers with disabilities in the workplace with a cross-fertilization approach between organization studies, the ethics of care, and a movement from the field of architecture and design that is called Universal Design (UD). It explores how organizations can use UD to develop more inclusive workplaces, first by applying UD principles to workspaces and second by showing how UD implies an integrative understanding of inclusion from the workspace to the workplace. (...) Moreover, this paper discusses the ethical challenges and complexities that this design practice faces in regard to its applicability to diverse organizations and industries. Finally, this paper demonstrates that inclusion requires abandoning any notion of a perfect, productive body and, therefore, recognizing our shared vulnerability and fundamental interdependence in the workplace. (shrink)

ASEAN agricultural workers represent one of the most vulnerable groups of workers regardless of citizenship. While bilateral agreements focus on general migration governance mechanisms, the specifics of agricultural workers’ rights and protections fall outside their scope. Due to the seasonal nature of cross-border agriculture, these are flexible precarious workers readily available to employers in the borderlands that often do not invest in worker health and social security. The Article reveals how foreign migrant agricultural workers (...) with and without work permits continue to fall between the gaps of national labor protection laws, due to both legal structural exclusions as well as the particular vulnerabilities of being noncitizen workers in remote, unsafe workplaces. This Article documents some of the developments during 20172019 in migrant employment in export cash crops. The next challenge for the future is developing mechanisms for bilateralism to lower migration costs, with a commitment to genuinely safe migration, as well as the establishment of long-term equitable working conditions for all migrant workers. The major findings demonstrate how the two main reasons for the discrepancies between the BLA and labor protections have to do with the noninterventionist approach of ASEAN and a series of technical exclusions in Thailand’s labor law and regulation. (shrink)

International migration has a female face in the beginning of the twenty-first century; since at least 1990, a total of 49 percent of international migrants have been women (UN 2008).1 Many women relocate in pursuit of goals that they can’t realize in their countries of origin, and many women move on their own to developed countries as caregivers to the very old or the very young, as nurses to attend to the sick in hospitals, and as domestic workers.2 How (...) should we regard their decisions to do so? One way of thinking about such moves is to deplore the fact that women have to move in order to attain certain goals in their lives; it would be more desirable to live in a world that would not make such moves necessary... (shrink)

Drawing on insights from scholarship on contentious action frames, this article examines the framing of demands for social justice for migrant farmworkers in Spain, Italy and Canada during the COVID-19 pandemic. We focus particularly on how activists in each country aligned their action frames with prevalent public discourses on the essential contribution migrants make to agricultural production, the need to guarantee “health for all,” and “increased vulnerability” of migrants’ lives during the global health crisis. Using these diagnostic frames, activists in (...) the three countries called for secure legal status for all migrants. Drawing on the literature on contentious action frames, we then analyze if action frames advanced by activists during the COVID-19 pandemic “resonated” with the understanding of these issues by policymakers. We challenge an approach to understanding resonance in binary terms as either present or absent. Instead, we introduce the notion of “ambivalent resonance” to draw attention to the fact that some frames are accepted only partially or only by some policymakers but not the others, as was the case in the three countries under study. We then situate this ambivalent resonance in the context of immigration priorities and recent trends in immigration policy development in these three countries and suggest that activists can build on ambivalences to advance migrant rights to status. (shrink)

A growing and substantial body of research suggests that female sex workers play a disproportionately large role in the transmission of HIV in many parts of the world, and they are often referred to as core groups by epidemiologists, mathematical modellers, clinicians and policymakers. Male sex workers, by contrast, have received little attention and it is not known whether it is helpful to conceptualize them as a core group. This paper draws upon ethnographic research documenting social and sexual (...) networks in London and looks at the position of five male sex workers within a network comprising 193 men and seven women (as well as 1378 anonymous sexual contacts and 780 commercial contacts). In so doing, it suggests that there is no evidence to show that male sex workers are more or less likely to acquire or transmit HIV in the course of commercial sex compared with other types of sexual relationships. In addition, men engaging in non-commercial sex all reported having unprotected sex in a variety of contexts and relationships and there is no evidence to suggest that men who are not sex workers play less of a role in the transmission of HIV. In short, these data suggest that it would be inappropriate to conceptualize male sex workers as a core group. This is not to suggest that public policy should continue to overlook male sex workers. New and inventive approaches are required to reach out to a vulnerable but diverse group of men, selling sex for a variety of reasons; even if these men are no more vulnerable to acquiring and/or transmitting HIV than other men and women that form part of their network. (shrink)

Pope Francis’s encyclical Fratelli tutti elevates some key themes of his papacy. Using the parable of the Good Samaritan as a framing narrative, Francis outlines an active, nonviolent style of politics and social engagement based on practices of attention and hospitality toward one’s neighbors. Francis refers to this mode of engagement as “social friendship.” Francis’s pastoral letters and homilies draw from the content and methodologies common to Latin American liberation theology, but many of his insights are mirrored in an Anglo-American (...) context through the witness of the Catholic Worker movement. This paper looks to the Catholic Worker for a mode by which the Gospel of social friendship can be lived out through asceses of attention and hospitality to the unhoused. Social friendship leads one to responsible action, and universal membership in the Body of Christ calls into question the structures that oppress the vulnerable. (shrink)

Responses to COVID-19 have been characterized by rapid border closures that have transformed the pandemic from a crisis of health to a crisis of mobility. While Canada was quick to implement border restrictions for non-citizens like refugees and asylum seekers, exemptions were made for some migrant groups like temporary workers. The pandemic marked a departure from who is considered worthy of admission to Canada. In fact, the border through restricted and securitized measures has filtered desirable versus non-desirable migrants, creating (...) a hierarchy among migrants within Canada’s immigration system by categorizing groups into those deserving versus non-deserving of admission. Deeply embedded societal discrimination and structural inequalities means that COVID-19 has exacerbated the vulnerabilities of migrant groups more than others. COVID-19 has placed an uneven burden on refugees who face increased border restrictions, significant health and safety risks, and limitations in accessing human rights. This paper documents the challenges, social and economic impacts, and exacerbated vulnerabilities border closures have imposed on refugees, asylum seekers and temporary migrants. We assess the many challenges that COVID-19 has created at the intersection of border studies, security resilience and human rights. We employ the conceptual frame of security resilience to critically analyse the dynamics of how and why border strategies have restricted migrant groups in times of crisis and amounted to an unjustified weakening of refugee rights. Finally, we argue that social resilience, which is rooted in rights-based strategies, not only ensures that societies are prepared to meet external shocks and disruptions, but that policy responses mitigate societal discrimination and inequalities. We highlight these strategies as effective mechanisms for reconciling both public health concerns and the rights of migrants to create more cohesive societies in times of crisis. (shrink)

The accession and implementation of new generation free trade agreements bring numerous opportunities as well as challenges to Viet Nam, regarding trade, labor and investment. The increasing number of workers abroad puts a pressure on Vietnamese government to support them in new working cultures and environments. The application of chatbot, which has been known to help certain vulnerable groups such as patients, women and migrants could be one of the tools to support Vietnamese migrant workers by providing (...) immediate information, network connection and consultation. Analyzing the results of the qualitative interviews with 11 migrant workers and the group discussion with two sections from three public social media groups and three active informants, the article argues that migrant workers as a vulnerable group who are supposed to be promising users of chatbot due to their great demand and needs, may have a complicated form of trust and expectation in chatbot. (shrink)

Liberals are concerned with the equal moral status of all human beings. This article discusses what flows from this premise for moral cosmopolitans when analysing temporary foreign worker programs for low-skilled workers. Some have hailed these programs as a tool to achieve redistributive global goals. However, I argue that in the example of Live-In-Caregivers in Canada, the morally most problematic aspect is that it provokes vulnerability of individual workers. Once in a situation of vulnerability, important conditions of individual (...) autonomy are jeopardized. Even if these programs provide for redistribution of opportunities on a global scale, the challenge such programs pose to the conditions of autonomy can not outweigh these gains. Instead, they need to be re-assessed and changed to fundamentally express equal moral status of all human beings. (shrink)

Ethics practice is both relative and situational. Perhaps there is an area of no greater demonstration of these realities than where an organization, be it a public governmental entity and/or a quasi-governmental entity with government contracts has the duty of care owed to a vulnerable constituency as well as to other community stakeholders. These agencies have the public trust as well as the ethical caretaking concerns to master. In the following fact scenario and discussion, one would consider a situation (...) where the care of the vulnerable constituency is the paramount concern and the facilitation of that care is also in question. Human Resource and leadership teams need to be cognizant of not only impropriety of members within their organization but also the appearance of impropriety as well. The following case study attempts to put into perspective the need for managers and HR representatives to monitor practice and perception of ethical behavior. (shrink)