Following a disputed review of a paper submitted to this journal the present paper seeks to raise the profile of some of the issues involved when the research community engages with vulnerable people. The paper is unashamedly polemical. It argues that this is a dangerous time for vulnerable people and that current protections are inadequate. The paper suggests the need to re-evaluate the whole relationship between the scientific community and vulnerable people but also tries to identify some practical and immediate improvements that could be made.

In this response to the commentary on our original article (Clements, Rapley, & Cummins, 1999), we examine the rhetoric of the commentary as well as some of the substantive issues raised. Although there are areas of agreement we challenge some of the views put forward in the commentary, particularly those related to the institutional power of ‘‘science’’, the questions of accountability and the involvement of vulnerable people in research decision making. We argue strongly for action now to increase the checks and balances in the system and to promote more vigorously examples of good practice.