Friday, June 17, 2011

Dignity of Risk

I recently came across the term "Dignity of Risk" and I thought I would share it because I loved it. To allow a person to take a risk is to acknowledge that person's dignity. It think it is related to what I was trying to explain with my Empowerment vs Caring For blog.

Here are a couple of links on Dignity of Risk:

A Few Words About Dignity of Risk

Managing the Dignity of Risk (blog by Robert Perske who seems to be quoted by a lot of people talking about the topic)

I have seen a case manager actually sabotage a person's attempts to find independent housing, even though that person had been deemed competent to make the decision to live independently. The case manager did not feel the person could be successful and was trying to protect her. Yes, living independently was risky for the client, but wasn't it her choice to make, not the worker's? This was robbing the client of her dignity.

However, when I talked to the case manager, she felt personally responsible for keeping the client safe - she felt if anything happened to the client, it would be her fault.

There are many grey areas - like when the person has been deemed incompetent, or when the service provider feels the person does not understand the risks involved. I think that there also needs to be more support for service providers who do allow their clients a degree of risk. Currently, our system seems to be set up so that service providers get in trouble when they allow too much risk, but not if they limit risk too much. It therefore makes sense that service providers would err on the side of caution.

Allowing dignity of risk needs to come from the top-down in our healthcare system, as well as from the bottom up.

As a service provider, what can we do? If there is a situation we are unsure about, discuss it with others. Ethics committees can be a great resource. Really, seriously consider if we are giving as much dignity of risk as we can. We need to ensure our clients understand the risks they are taking. And of course, we also need to very carefully document all of our reasoning.

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