Dignity of Risk vs. Duty of Care:

When Duty of Care Becomes the Biggest Risk.  

 

The concept of dignity of risk reminds us that individuals with disabilities deserve the right to make choices, take risks, and experience life fully—just like everyone else. As Perske put it, “there can be such a thing as human dignity in risk, and there can be dehumanizing indignity in safety” (Perske, 1972). However, as practitioners, we’re also bound by a duty of care—a legal responsibility to protect individuals from foreseeable harm by taking reasonable steps to ensure their safety. But when duty of care goes too far, we risk creating restrictive or even prohibited environments that are more about control than empowerment. 

Duty of Care: Legal Responsibility and Boundaries 

Duty of care often becomes synonymous with keeping people safe from harm. Legally, it requires taking reasonable steps to prevent foreseeable risks. But applied too rigidly, duty of care can cross into restrictive practices that limit autonomy, from guiding choices—like offering only three options instead of an open-ended choice—to more overtly controlling actions that can become prohibited practices. For example, we may limit choices to support communication skills, like offering structured options to reduce overwhelm. While this can help individuals make decisions at their level of understanding, we need to continually ask: Is this restriction necessary for their growth, or are we imposing it for our convenience or comfort? Our role is to provide the least restrictive support that fosters safe and meaningful autonomy. 

Recognising Everyday Risks 

Consider the risks we all take daily that impact on our immediate situations and our futures. Do you drive? Do you sometimes glance at your phone while driving? Do you eat leftover pizza for breakfast or skip flossing your teeth? Do you book holidays, ski, or walk across busy roads without using a crossing? Have you ever shared an opinion online, committed to a lifelong relationship, or had a few drinks and gone dancing? Do you invest your superannuation without fully knowing where your funds are allocated, open a new NDIS business, or take on the challenge of studying, working, and raising children simultaneously? 

Each of these actions involves a risk—some with minor, immediate impacts, others with potential long-term consequences. Yet, they’re all choices we make, exercising our freedom and autonomy, and they are all imperative to ongoing personal growth and a meaningful life. The people we support, however, often don’t get the opportunity to make these kinds of choices. The risks they’re “allowed” to take are often limited by external judgments and assumptions about what’s best for them, sometimes at the expense of their dignity and autonomy. 

The Cost of Overprotection and the Long-Term Risks 

In focusing too heavily on immediate physical safety, we can overlook deeper, long-term risks that affect mental health, personal development, and quality of life. Overprotectiveness can lead to several serious consequences, which may be less visible but no less impactful: 

• Mental Illness

  Some of the leading causes of mental health challenges are loneliness, discrimination, and isolation—experiences that many of the people we support know all too well. When combined with a restrictive life, the risk of mental health struggles becomes significant for people with disabilities. 

• Loss of Dignity

  When we control too much, individuals can lose their sense of self-worth and respect, both in their own eyes and in others’. They may also lose the ability to exhibit calm, mature behaviours that are often learned through trial, error, and growth. 

• Loss of Growth and Development

  Without opportunities to explore new experiences, make mistakes, and discover their preferences, people miss out on important pathways for growth. The ability to make mistakes is essential for skill development, continual growth, self-discovery, and understanding one’s likes, dislikes, preferences, and values. 

• Loss of Freedom

  Freedom includes making choices without undue influence or restriction. The question arises: Is it riskier to let someone walk independently and perhaps trip or lay on the pavement, or to confine them indoors to prevent the risk of tripping? By focusing solely on physical safety, we can compromise their ability to live freely and fully, which is a key component of a meaningful life. 

Understanding Our Own Position on the Spectrum 

As professionals, it’s important to be self-aware and to recognise where we sit on the spectrum between duty of care and dignity of risk. Often, our personal anxieties and societal norms shape our perception of what is an “acceptable” risk for others. This awareness helps us avoid overly restrictive practices that may reflect our own comfort more than the individual’s actual needs and desires. 

Ask yourself: 

• Are my actions overly focused on immediate physical safety at the cost of long-term dignity and autonomy? 

• Am I applying rules designed for myself to others without considering their unique context or preferences? 

• Do I understand the long-term risks of limiting autonomy, such as mental illness, loss of freedom, and stunted personal growth? 

Balancing Safety and Autonomy for a Meaningful Life 

Ultimately, we need to remember that risk-taking is essential for a meaningful life. What are the riskiest decisions you make every day? Some choices may impact the next few minutes, others your week, and some shape your future. The same goes for the people we support—their risk-taking today could build a more fulfilled, autonomous future. 

As practitioners, our goal should be to balance duty of care with dignity of risk, helping others live lives that are not just safe but also rich, dignified, and meaningful. We must aim for a support model that respects the individual’s right to make decisions, take risks, and live without undue control. This approach requires courage, empathy, and a willingness to embrace uncertainty—not just for those we support but also for ourselves as caregivers, always striving to let people live the life they choose, with all its inherent risks. 

Share this article and/or let us know your thoughts! Are you a behaviour support practitioner wanting to level-up your practice? Reach out to us at melanie@tothemoonandback.net.au or check out our website https://launchsupervision.com.au/