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Dignity of risk in the community: a review of and reflections on the literature

Marsh, P ORCID: 0000-0002-4371-2628 and Kelly, L 2018 , 'Dignity of risk in the community: a review of and reflections on the literature' , Health, Risk and Society , pp. 1-15 , doi: 10.1080/13698575.2018.1519115.

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Abstract

Taking risks is a part of everyday living, and a contributor to our sense of dignity. Yetas people age, or develop cognitive, mental or physical impairments, opportunities totake risks can diminish. A life without risks can erode a person’s dignity. The purposeof this narrative review was to explore the application of the concepts of the Dignity ofRisk and Therapeutic Risk in literature pertaining to community-based support forpeople living with a range of physical, mental and/or cognitive constraints. We aimedto understand how these concepts are conceptualised, articulated, negotiated andenacted in theory and practice. During a period from October 2017 to January 2018,seven databases were searched for relevant literature. Thematic analysis techniqueswere applied to synthesise the data from 47 academic papers that met the inclusioncriteria. Our analysis demonstrates persistent ethical tensions. There is widespreadsupport for the application of both concepts across a range of discourses, but a numberof long-standing ethical considerations pertaining to risk, safety, rights and negotiationpersist. We argue that the way forward is to resist the temptation to simplify the issues,but instead to accept and accommodate ethical complexities while implementingevidence-informed solutions such as intersubjective risk negotiation strategies, community-centredrelational approaches to decision-making, and education and training incommunication skills and the positive potential of risk. Future research to examine theimpacts of the implementation of these strategies would be timely, beneficial andwelcome.

Item Type: Article
Authors/Creators:Marsh, P and Kelly, L
Keywords: dignity of risk, therapeutic risk, ageing, cognitive impairment, mental health
Journal or Publication Title: Health, Risk and Society
Publisher: Carfax Publishing
ISSN: 1369-8575
DOI / ID Number: 10.1080/13698575.2018.1519115
Copyright Information:

Copyright 2018 Informa UK Limited, trading as Taylor & Francis Group

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