12 minutes
Dignity of risk Learn how to respond to a choice you would not make in a way that keeps the person's authority intact and your obligations met.
What you’ll be able to do Distinguish dignity of risk from neglect, and describe a response to a risky choice that neither overrides the person nor abandons them. Compare the responses to this question and explain your choice: What is the most useful response? Document a next step for Dignity of risk: Recall one choice by a person you support that made you uncomfortable, and write down what information and support you offered. The harm of too much protection Every adult takes risks, and learning from them is how people become capable. People with disabilities have historically been denied this, on the grounds that they might be hurt, and the result has been lives so protected that nothing in them was chosen. Dignity of risk is the name for the principle that this protection is itself a harm, and that the right to make decisions includes the right to make ones that may not work out.
The principle is easy to state and demanding to practice, because it asks staff to sit with discomfort. The test of practice is not whether you feel comfortable with a person's choice. It is whether they had what they needed to make it, whether the risk was reduced as far as they wanted it reduced, and whether there is a way back that does not punish them for having tried.
Dignity of risk or neglect? The person chooses to manage their own medication after being shown a system and offered weekly check-ins.
Choose a category Dignity of risk Neglect The person is left to manage their own medication after asking for help and receiving none.
Choose a category Dignity of risk Neglect The person chooses to travel alone by bus after practicing the route with a worker and carrying a card with contact numbers.
Choose a category Dignity of risk Neglect The person is told to figure out the bus because staff are short that day.
Choose a category Dignity of risk Neglect The person declines a recommended service after hearing what it offers and what declining it means.
Choose a category Dignity of risk Neglect The person is not told a service exists because staff assume they would not manage it.
Choose a category Dignity of risk Neglect Check matches Reset Four questions for any choice that worries you Does the person have the information? Not a warning; information. What the risk is, how likely it is, what has happened to others, and what would reduce it. In a form they can use, and with time to think.
Have the alternatives been offered honestly? An alternative described as the safe option and the person's choice described as the risky one is a steer, not a menu.
What support would reduce the risk they choose to take? Almost every risky choice has a supported version. Finding it is the work; not finding it is where neglect starts.
What is the way back? A plan for what happens if it does not work, agreed in advance, that does not read as failure or as proof the person should not have tried.
Convert the risk list into a support list What you can change You control whether a list of concerns ends a conversation or starts a plan. The same list can do either.
What to watch for Do not let a documented risk become a documented reason. A risk is a design input, and a reason is a decision made for the person.
Your next step Take the next risk list you see and write a support next to every item on it.
Carry this forward Dignity of risk means that the right to make choices includes choices that may not work out, and that protection from all risk is also a form of harm.
The response to a risky choice is to make sure the person has the information, the alternatives and the support to reduce the risk they choose to take, not to remove the choice.
Neglect is failing to provide information, support or a safety net; it is not respecting a decision you disagree with.
A sort distinguishing respect for risk from neglect, a scenario decision and a knowledge check.
Recall one choice by a person you support that made you uncomfortable, and write down what information and support you offered.
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Reset this lesson
Previous lesson Next lesson Carry this into practice What it means for a person to direct their own supports, where the independent living movement came from and what it asks of a service system, and how to support a decision without taking it over.
Return to the experience: What did you notice or try, whose perspective informed it, and what would you keep or adjust?
Participation and course completion in this program do not count toward DHS-required training credits unless management, a director, or DHS leadership expressly approves an exception.
