10 December 2021
Focusing attention on vulnerable subjects recurs systematically in the activity of the Italian Committee for Bioethics (ICB) and has characterised many of its opinions. In this Document, the ICB, in underlining the ethical and legal relevance of the issue of vulnerability, addresses a particular aspect: the relationship between vulnerability and "places of care", understood not only as the institutional apparatus of care, but also as provider of moments of attention and listening. Today, in light of the economic and political limitations of the Welfare State, it appears increasingly essential to encourage the development of "Community Welfare" in which individuals, families, associations seek, with the state and beyond the state, to build new forms of encounter and assistance. This need is also expressed in the National Recovery and Resilience Plan through the creation of the so-called "Community Health Houses" in which health care is supported and strengthened by the creation of places where social care is closely linked to listening to the needs of the weakest and most fragile subjects. In this reform project we return to the original plan of the health reform, centred on the protection and promotion of health as a multifaceted human dimension, stemming from which is the attention paid to the psychological and social, as well as the biological, determinants of health itself.
Starting from the reflection on vulnerability, in its profound link with the ethics of care (understood as 'taking care'), the Committee draws attention to these experiences in order to define the multiple potential applications of a model called "Ethical space”, intended as a place in which to listen, encounter others and exchange personal and professional life experiences to give voice to individual citizens and the associations representing them. In fact, the ethical issues go well beyond the biomedical dimension and affect different dimensions of social life in which particular situations of vulnerability emerge and are especially evident, not only in health facilities, but even in schools, prisons, courts: these situations are taken into consideration, at an emblematic level, in the opinion.
"Ethical spaces" could therefore take form and find implementation in different areas and social contexts, since it is an experience that could, and should hopefully extend to all "ethically sensitive" areas in which the relational dimension and vulnerability are manifest and converge: workplaces, universities, the various reception centres for migrants, etc. It is precisely the diversity of these experiences that highlights how it is not possible to indicate a defined institutional model and a precise organisational structure. The ICB is aware that it is putting forward a project which, due to its novelty, needs to be defined and consolidated through further reflections within each individual context, however, it is convinced that the future implementation of ethical spaces will derive from the solicitation to think differently about the possibility of building more careful forms of assistance and protection of vulnerable subjects, in the various forms in which vulnerability can manifest itself in society, even beyond the dimension of health.
Lastly, the opinion underlines how ethical space constitutes an important tool for promoting a public debate aimed at informing, training and consulting citizens in order to make them more aware of their choices, strengthening their role in the governance of society on emerging ethical problems. It is also an institutional task of the ICB: some initiatives have already been undertaken (conferences for schools and meetings with citizens), however the ICB believes implementation of this area to be necessary and urges the Government to take steps in this direction.