This article presents a statement by the Strategic Alliance of Catholic Research Universities (SACRU) working group on the place of vulnerability in healthcare (look at Riconoscere e rispondere alla vulnerabilità in tempo di COVID-19). The statement makes the case for vulnerability to be considered a basic human capacity that is a necessary condition for trust, morality and human flourishing, and ends with a call to healthcare providers to “create spaces of trust where people can be vulnerable safely so as to enable their integral flourishing.”

The statement is the outcome of a series of interdisciplinary webinars and an in-person workshop in Rome during which doctoral candidates from seven SACRU member universities presented papers based on their own doctoral projects in relation to the topic of vulnerability and healthcare. The topics of the research projects of the collaborating doctoral candidates included: the concept of boundary in environmental ethics (Gabriel Vidal Quiñones), virtues in Aristotle and Thomas Aquinas (Jefferson Belarmino), healthcare in mediaeval monasticism (Enrico Frosio), conceptions of suffering and compassion in physician assisted suicide and euthanasia (Geetanjali Rogers), quality of informed consent for vaccine trials in developing countries (Aitana Juan Giner), comparative theological bioethics of prenatal genetic testing (Dorothy Lee Goehring), interreligious dialogue in healthcare as a means of increasing social coherence in war settings (Joana Ramos), and environmental, ecological and social justice in aged care (Lachlan Green).

In addition to the authors of the statement, the working group’s academic representatives of member universities who supported the development of this statement are David Kirchhoffer (Australian Catholic University, Chair), James Keenan (Boston College), Aleksandra Goss (Pontificia Universidad Católica de Chile), Luca Valera (Pontificia Universidad Católica de Chile) Jorge Ignacio Fuentes (Pontificia Universidad Católica de Chile), J. Landeira-Fernandez (Pontifícia Universidade Católica do Rio de Janeiro), Luis Anunciação (Pontifícia Universidade Católica do Rio de Janeiro), André Azevedo Alves (Universidade Católica Portuguesa), Simona Beretta (Università Cattolica del Sacro Cuore), Mar Rosàs (Universitat Ramon Llull), and Elena Carrillo (Universitat Ramon Llull). Look at the Working Group’s SACRU website.

The SACRU Working Group 1, 7 April 2025

Based on the inputs of each of the doctoral candidates, and with assistance from the academic members of SACRU working group 1, the following final statement was presented by the doctoral researchers at a public event hosted at the Rome Campus of Australian Catholic University on 7 April 2025 to coincide with the Jubilee of the Sick and Health Care Workers.

The statement

1. All natural systems, species, and individuals are capable of being harmed. At the same time, this state of precarity is a necessary condition for the flourishing of natural systems, species and individuals in accordance with their nature. Living beings risk harm in order to compete or to cooperate to realise goods for their flourishing. In nature, cooperative relationships establish a condition in which risk of harm is reduced and mutual flourishing is enhanced. We describe this unconscious reality as ‘proto-trust’.

2. Human beings, as beings endowed with a set of capabilities among which are reason and free choice, are not only capable of being harmed, but capable of recognising their own and others’ capacity to be harmed, and to respond to this through moral behaviours in ways that, though risking harm, establish trust, and so reduce the mutual risk of harm thereby promoting individual and collective flourishing.

3. Vulnerability, as this capacity to be harmed, to recognise the risk of harm in oneself and others, and to respond to this through moral behaviour (free actions), is therefore both a fundamental equaliser of humanity and a condition of possibility for human flourishing and moral conduct.

4. Vulnerability allows us to recognise the significance of trust. When human beings choose to risk harm in an effort to create mutual flourishing, they promote conditions of trust. Vulnerability, therefore, makes trust possible and trust is necessary to allow people to take risks for their own and others’ flourishing. People encounter and engage trust, and they receive the goods that flow from it, because they are essentially vulnerable.

5. In the Christian tradition, human beings are created in the image of God, who is vulnerable. God chooses to be vulnerable by respecting human freedom. In the mystery of the incarnation and redemption, we see God’s acute experience of vulnerability, and we learn how the fact of our own vulnerability is the condition of possibility for life-giving action on behalf of those most in need.

6. In Matthew 25, when Jesus says, “I was naked and you gave me clothing, I was sick and you took care of me”, we are invited to recognise the precarity of another, and in that, we discover the vulnerable nature and agency of Christ, and therein, are invited to participate in that vulnerability. This is in essence the mission of Christian healthcare.

7. Human health and human salvation are related through the Latin root, salus. Human health, therefore, is about more than merely the absence of physical and biological precarity. It is about achieving a state of physical, psychological, moral, and spiritual flourishing in communion with others, the natural world and God.

8. The acute awareness of our precarity when we experience infirmity, affects us at all these levels of our being. This precarity is part of our vulnerability and is ameliorated only when we can express our vulnerability in relationships of trust.

9. When we seek health care, we are seeking these relationships of trust that enable us to express our vulnerability in ways that address our desire for integral flourishing.

10. For some people and social groups, the experience of precarity is more acute because of their social location. It may mean that for people who are part of these groups, the capacity to take actions that risk harm in order to achieve health is limited due to justifiable mistrust. Their negative social experiences point to the failings, and therefore, precarity, of healthcare as a social institution to adequately address the vulnerability of all human persons.

11. Therefore, there is a moral imperative for healthcare institutions and individual providers to create spaces of trust where people can be vulnerable safely so as to enable their integral flourishing.

[SACRU Working Group 1 would like to acknowledge the support of SACRU Research Mobility Funding that made the in-person workshop and public event possible. A full recording of the event is available on YouTube].