Philip J. Nickel

This paper advances a new criterion of a vulnerable population in research. According to this criterion, there are consent-based and fairness-based reasons for calling a group vulnerable. The criterion is then applied to the case of people with serious illnesses. It is argued that people with serious illnesses meet this criterion for reasons related to consent. Seriously ill people have a susceptibility to “enticing offers” that hold out the prospect of removing or alleviating illness, and this susceptibility reduces their ability to safeguard their own interests. This explains the inclusion of people with serious illnesses in the Belmont Report’s list of populations needing special protections, and supports the claim that vulnerability is the rule, rather than the exception, in biomedical research

According to assurance views of testimonial justification, in virtue of the act of testifying a speaker provides an assurance of the truth of what she asserts to the addressee. This assurance provides a special justificatory force and a distinctive normative status to the addressee. It is thought to explain certain asymmetries between addressees and other unintended hearers (bystanders and eavesdroppers), such as the phenomenon that the addressee has a right to blame the speaker for conveying a falsehood but unintended hearers do not, and the phenomenon that the addressee may deflect challenges to his testimonial belief to the speaker but unintended hearers may not. Here I argue that we can do a better job explaining the normative statuses associated with testimony by reference to epistemic norms of assertion and privacy norms. Following Sanford Goldberg, I argue that epistemic norms of assertion, according to which sincere assertion is appropriate only when the asserter possesses certain epistemic goods, can be ‘put to work’ to explain the normative statuses associated with testimony. When these norms are violated, they give hearers the right to blame the speaker, and they also explain why the speaker takes responsibility for the justification of the statement asserted. Norms of privacy, on the other hand, directly exclude eavesdroppers and bystanders from an informational exchange, implying that they have no standing to do many of the things, such as issue challenges or questions to the speaker, that would be normal for conversational participants. This explains asymmetries of normative status associated with testimony in a way logically independent of speaker assurance.