Grey Matters January 10, 2025

Grey Matters: Dignity of Risk

Notes from the Support Approach Team

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Grey Matters: Dignity of Risk

What is Dignity of Risk?

The term “Dignity of Risk” was coined by Robert Perske in 1972 in response to what he thought of as the “indignity of overprotection of people with [intellectual disabilities].”

So, what does it mean?

  • People with acquired brain injury, cognitive or intellectual impairments have the same ethical and moral rights as any other adult.
  • These individuals should be afforded the dignity of being allowed to take risks

But I want to protect the people I support!

  • It is natural for people in supportive and caregiving roles to want to protect the people we care about.
  • Risk is a part of life, and being able to take risks contributes to autonomy and self-determination, as well as new experiences and learning opportunities.
  • People in caring positions tend to overestimate risks, meaning that we may believe that a risk is more serious than it actually is.
  • When we overestimate risk, we might deny peoples’ autonomy, reduce their motivation, restrict their options for activities, or lessen their communication skills.

But what if they can’t understand the risks?

  • Of course, we need to also consider a person’s ability to understand the risks they are taking, and the potential consequences.
  • This is where collaboration and shared decision-making come into play!
  • When we can work together as a team, keeping the individual’s rights, needs, and wants in mind, we can help them to understand the potential risk of any situation, and come to a safe decision.
  • Creating rapport with the individuals we care about can help them to see us as a trusted resource, or someone they can come to for advice when they aren’t sure about something.

What type of risks can the individuals we support take?

  • More independence with routines: We can support more independence with things like cooking, cleaning, taking public transit, etc.
  • Relationships: Everyone deserves the right to engage in friendships or romantic relationships, even though there is a risk of being hurt emotionally.
  • Trying something new: Try a new sport, activity, or something like an open mic night or karaoke!

Madeline Strandberg

Support Approach Consultant

References

Chicoine, B., & Kirschner, K. L. (2022). Considering dignity of risk in the care of people with intellectual disabilities: a clinical perspective. Perspectives in biology and medicine65(2), 189–198.

Marsh, P., & Kelly, L. (2018). Dignity of risk in the community: a review of and reflections on the literature. Health, Risk & Society20(5–6), 297–311. 5