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Vulnerability: Personal, Communal and Professional
Vulnerability means: “loss of opportunities to live better, loss of abilities to live well, and, at its extreme, loss of living.”1 A common definition of vulnerability is: “capable of being physically or emotionally wounded.”2
Based on these definitions, at some point in our lives we are all vulnerable, first as infants and children, then if we are injured, become ill, experience loss of income, housing and/or education and . . . as we age. We might also be vulnerable if we are members of a particular group, are in relationships with others, live in particular part of the world and/or experience a natural or manmade disaster . . . even a pandemic. Vulnerability may be transient or it may be permanent. We may be vulnerable in one setting but not another. For these reasons, a collective need to be sensitive to and accommodating of vulnerability exists. As dental professionals, this is especially important and embodied in the American Dental
Association Principles of Ethics & Code of Professional Conduct which defines a “true professional” as possessing the “[q]ualities of honesty, compassion, kindness, integrity, fairness and charity . . .”3
The preamble goes on encourage each dentist to “share in providing advocacy to and core of the underserved.”3
Nanette Elster, JD, MPH, FACD
Communications Director, American College of Dentists and Editor, eJACD Associate Professor, Neiswanger Institute for Bioethics Loyola University Chicago Stritch School of Medicine
This issue of the eJACD highlights some aspects of vulnerability that arise not only for dentists themselves, but for their patients and their communities. The articles in this issue look at very broad issues as well as more specific vulnerabilities. The issue begins with a chronological history of how the American College of Dentists has grappled with issues of vulnerability and the questions of equity it raises in “Through the Years: The American College of Dentists’ Response to the Challenges of Access and Equity Among Vulnerable Populations” by Theresa Gonzales.
Taking us to the present, Cesar Sabates considers the role of dentists in improving health equity in his piece, “Taking a Stand on Oral Health Equity: Data Show Oral Health Care System Falls Short of Meeting Needs of Entire Population.” In addition to a general discussion about how improving equity and addressing vulnerability is critical to the profession and is an ethical imperative, articles also address specific populations. Highlighting the intersectionality of vulnerabilities, Cothron, Shaver and Boynes present their research in, “Chronic Disease and Rurality Impacts Veteran Oral Health Outcomes: A Behavioral Risk Factor Surveillance System Analysis.” Toni Roucka, in her article, “The Challenging Plight of Refugees” writes a moving narrative of her experience working with refugees, sharing her and her colleagues’ work with a young refugee women and how the trauma of the woman’s experiences impacted her care. And, taking into consideration the vulnerabilities that exist within the profession and how those vulnerabilities were heightened particularly for students and educators during the Pandemic, Alexander DeGenova, presents, “The Vulnerability of Dental Students: A student perspective on stress, regulation & loss during COVID-19.”
The articles in this issue, ranging from personal narratives to empirical research touch on some of the general and specific challenges confronting the profession with regard to patient, student, and practitioner vulnerability. This discussion sets the stage for the Fall issue of the eJACD which will discuss the ethical imperative to improve access to care as way to address, in part, the burdens on the vulnerable and improve outcomes for all.
REFERENCES
1. Hoffmaster, B. (2006). What does vulnerability mean?. Hastings Center Report, 36(2), 38-45. 2. https://www.merriam-webster.com/dictionary/vulnerable Accessed on July 10, 2022. 3. American Dental Association. American Dental Association principles of ethics and code of professional conduct, with official advisory opinions revised to 2022. Available at https://www.ada.org/searchresults#q=principles%20of%20ethics%20and%20code%20of%20professional%20conduct&sort=relevancy
