摘要:A diverse panel convened in June 2011 to explore a dilemma in human research: some traits may make individuals or communities particularly vulnerable to a variety of harms in research; however, well-intended efforts to protect these vulnerable individuals and communities from harm may actually generate a series of new harms. We have presented a consensus statement forged by the panel through discussion during a 2-day meeting and the article-writing process. We have identified practical problems that sometimes arise in connection with providing additional safeguards for groups labeled as vulnerable and offered recommendations on how we might better balance concerns for protection with concerns for justice and participant autonomy. “Regrettably, the term ‘vulnerable’ too often gets played as a bioethical trump card, summarily tossed on the table in the course of debate, sometimes with the stern admonition that it would not be decent to exploit such subjects. Given the absence of agreed-upon standards for identifying and responding to vulnerability, such a move too often serves as a conversation-stopper, abruptly ending dialogue rather than furthering it. It may be possible to do better.” —K. Kipnis 1 (pG3) AS PART OF A SCIENTIFIC meeting enabled by a National Institute of Mental Health grant to help identify best practices for mental health research ethics, a diverse panel convened in June 2011 to explore a dilemma in human research: some traits may make individuals or communities particularly vulnerable to a variety of harms in research; however, well-intended efforts to protect these vulnerable individuals and communities from harm may actually generate a series of new harms. At a daylong public conference, individuals representing mental health consumers, research ethicists, medical sociologists, psychiatric researchers, and substance abuse researchers presented data and reflections from their own and others’ research. These panelists then met for a second day of closed meetings to explore ways of addressing the dilemmas arising in research with vulnerable participants. The group forged consensus through discussion during the 2-day period and the article-writing process.