Wednesday, August 05, 2009

The Dignity of Risk

Public guardians, at least in NH, occupy the unusual ground of being strong civil libertarians who nonetheless are the actual people who overrule their wards, making them submit to things they would not on their won. As a result, they are often very thoughtful about ideas of liberty, rights, and autonomy.

A guardian today, discussing a patient with a Narcissistic Personality Disorder and significant substance abuse issues (the youtube series I sent you, Ben) stated that a year ago, she had signed off on some pretty intense limitations of his autonomy, because he was so continually drunk and refusing his anxiety treatments that she felt he was not able to make a decision. But today, he has been sober some months and can at least verbalize what the consequences of drinking or missing treatment are (even more so, now that he is on Antabuse). She now will not agree to those restrictions, reasoning that he does appreciate what is in front of him, at least enough to have his decision honored.

She called it "the dignity of risk," and the phrase impressed me greatly. It bears significantly on national decisions about health care, privacy, and safety net. To take away risk is to unavoidably take away a certain amount of dignity.


Retriever said...

Yes! It is a concept that is also valuable when considering the decisions made by college age kids. The fledglings have to leave the nest, tho one fears they will crash or fly into dangerous territory...To use a crude analogy that I do not mean to offend anyone with: we had a cat killed by a raccoon (died slowly, until we realized the vet's care was only prolonging misery and put her to sleep). The vet lectured us that our next cat should be a indoor cat. No such thing. Better a free life, perhaps curtailed, so long as cat was reasonably healthy and agile, than a fat prisoner, bored and safe indoors.

terri said...

Great quote/phrase!

Be sure to tell her that all your blog readers say so!