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

Abstract

<p>Infants born to opioid-dependent women are typically admitted to neonatal intensivecare</p><p> units for management of neonatal abstinence syndrome (NAS), and their treatment</p><p> requires medical decisionmaking. It is not only the infants’vulnerability, in terms of their</p><p>incompetence and medical condition, that is present in those circumstances,but also the</p><p> mothers’ situational vulnerability,which arises with the possibility of their engagement</p><p> in medical decision making regarding their infants. Vulnerability is a concept that has</p><p> often, if not always, been traced back to individuals. In this paper, we suggest that in some</p><p> cases evaluations and attributions of vulnerability to either individuals or populations</p><p> fall short of capturing all aspects of vulnerability.We ask whether this individual-based</p><p>evaluation is sufficient for identifying all the vulnerabilities arising in the situation.</p><p> Moreover,we suggest that the “unit” of vulnerability attribution, typically a person who</p><p> is a likely target of harm and/or moral violations, should not simply be reduced to the</p><p> individual. Rather, the unit should in some cases be seen as constituted by an entity that</p><p> is interpersonal in nature. The kind of real vulnerability that we identify in this paper is</p><p> inherently embedded in a dyadic relationship, and notions of vulnerability that decompose</p><p>social relations into individuals run the risk ofmissing the vulnerability in question.</p><p>We elaborate this kind vulnerability by discussing of role of opioid-dependent mothers in decisionmaking about their infants’ treatment</p><p></p><p><br /></p>