Which is an example of a situation where deferential vulnerability might be a factor?

Which is an example of a situation where deferential vulnerability might be a factor?

A. An army medical officer recruiting subjects among lower ranks.

B. An employer recruiting among persons who directly report to him.

C. A physician recruiting his patient.

D. A college professor recruiting among his students.
 

Correct Answer: C. A physician recruiting his patient.
 

Explanation:  All of these examples are instances in which deferential vulnerability might play a role, but if I had to choose just one example, the most straightforward example is:
 

C. A doctor hiring his own patient.
 

Deferential vulnerability arises when prospective participants feel they have a duty of obligation towards someone with a superior status and authority over them. In the context of a physician-patient relationship:
 

1. Most patients tend to develop a deep sense of trust towards their physicians
 

2. Patients might worry that they will let their doctors down or have consequences affecting their treatment if they refuse
 

3. There is a built-in power imbalance within the relationship - doctors possess specialized expertise and decision-making power within healthcare 
 

4. Patients may feel they "owe" their physician participation or that participation will gratify their physician
 

Although all four situations have power imbalances that might create deferential vulnerability, the physician-patient relationship is of particular concern because it is one of personal health issues and is commonly filled with high levels of trust and dependence.
 

The other alternatives also entail genuine deferential vulnerability issues in the ethics of conducting research but the physician-patient relationship is a quintessential illustration of this particular ethical dilemma.