Certification for IRB Professionals (CIP) Practice Exam

In what situation might deferential vulnerability be prominent?

1. A physician recruiting his patients

2. A patient informing the doctor about their symptoms

3. A researcher asking for volunteers in a presentation

4. A participant discussing the study with friends

The correct answer is: A physician recruiting his patients

Deferential vulnerability often arises in situations where there is a power imbalance between individuals, typically in contexts involving authority figures and their subordinates. When a physician recruits their own patients for a research study, the inherent dynamics of the doctor-patient relationship become significant. Patients often trust their physicians and feel obligated to comply with their requests due to the perceived authority and expertise of the physician. In this scenario, the patients might feel vulnerable because they may believe that refusing to participate could negatively impact their relationship with the physician or the quality of care they receive. This deference to authority can compromise the informed consent process, as patients may not feel free to decline participation without fear of repercussions, whether real or perceived. In contrast, the other scenarios present less pronounced power dynamics. When a patient discusses symptoms, it reflects a typical behavior in a patient-physician interaction without the element of being asked to participate in research. A researcher presenting to volunteers does not inherently suggest vulnerability as individuals have the autonomy to choose to participate or not, and discussing a study among friends typically does not involve any coercion or authority. Therefore, the scenario of a physician recruiting patients distinctly highlights the concept of deferential vulnerability due to the existing trust and power gap between the physician and the