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Published on: October 23, 2020
A positive risk approach when clients choose to live at risk: a palliative case discussion
Christopher E De Bono1, Blair Henry
1aToronto Central Community Care Access Centre bJoint Centre for Bioethics cEmmanuel College & St. Michael's College, University of Toronto dDepartment of Family and Community Medicine, Division of Palliative Care, University of Toronto eEthics Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Purpose Of Review:
The article discusses recent approaches in the literature about clients who chose to live at risk in their homes. It argues for a positive risk-based approach and a tool to help manage risk in the home, and applies these to a hypothetical end-of-life scenario.
Recent Findings:
Historically, safety plans to consider risk management involved a culture of risk aversion supported by sometimes paternalistic motives intended to protect vulnerable clients. New findings in the literature engage in a process that respects the ethical principles underlying harm reduction philosophies. The literature also argues for a perspective that moves away from viewing risk as only harmful, to one that supports a positive understanding of risk as part of a client's informed choice.
Summary:
A risk support management plan, based on a positive approach, can provide a way to both support a client's choice to live at risk, anticipate for expected complications, and inform the creation of a contingency plan to address concerns as they may arise. The added value of a structured approach like the one proposed here for risk support management plans is that it provides adequate due diligence and informed decision-making when planning for risk-taking in complex situations.
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