A1 Journal article – refereed
OPIOID-DEPENDENT MOTHERS IN MEDICAL DECISION MAKING ABOUT THEIR INFANTS’ TREATMENT: WHO IS VULNERABLE AND WHY?




List of Authors: Susanne Uusitalo, Axelin Anna
Publisher: Centre de recherche en éthique de l’Université de Montréal
Place: Ontario
Publication year: 2017
Volume number: 12
Issue number: 2-3

Abstract

Infants born to opioid-dependent women are typically admitted to neonatal intensivecare


units for management of neonatal abstinence syndrome (NAS), and their treatment


requires medical decisionmaking. It is not only the infants’vulnerability, in terms of their

incompetence and medical condition, that is present in those circumstances,but also the


mothers’ situational vulnerability,which arises with the possibility of their engagement


in medical decision making regarding their infants. Vulnerability is a concept that has


often, if not always, been traced back to individuals. In this paper, we suggest that in some


cases evaluations and attributions of vulnerability to either individuals or populations


fall short of capturing all aspects of vulnerability.We ask whether this individual-based

evaluation is sufficient for identifying all the vulnerabilities arising in the situation.


Moreover,we suggest that the “unit” of vulnerability attribution, typically a person who


is a likely target of harm and/or moral violations, should not simply be reduced to the


individual. Rather, the unit should in some cases be seen as constituted by an entity that


is interpersonal in nature. The kind of real vulnerability that we identify in this paper is


inherently embedded in a dyadic relationship, and notions of vulnerability that decompose

social relations into individuals run the risk ofmissing the vulnerability in question.

We elaborate this kind vulnerability by discussing of role of opioid-dependent mothers in decisionmaking about their infants’ treatment



Downloadable publication

This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail. Please cite the original version.




Last updated on 2019-20-07 at 11:22