[The stigma of vulnerability and the autonomy fallacy in care. Ethical keys from a relational anthropology]

Vulnerability has become a bridging concept capable of traversing clinical bioethics, research ethics, and contemporary discussions on social justice, without a stable consensus on what the term exactly designates, what it normatively justifies, and how it is operationalized in specific contexts. This article offers an argumentative synthesis based on a systematic literature review (January 2015-August 2025) conducted in PubMed, Scopus, and Web of Science. This study, inspired by PRISMA, identifies four thematic areas encompassing the most significant ethical challenges and emerging approaches in both care and research with vulnerable individuals and populations. The discussion concludes that the ethical quality of clinical, institutional, and regulatory responses depends on achieving a balance between protection and inclusion through personalized assessment. This approach avoids both stigmatizing labeling and preventive exclusion, which compromises equity in care. The reviewed literature supports the notion that reducing vulnerability to a lack of autonomy is conceptually flawed and normatively dangerous.