This last week, Colorado voters legalized the use of recreational marijuana for people age 21 and older. Among myriad arguments surrounding this law, we have heard the age-old question about the role of society in protecting people from themselves. Seat-belt and motorcycle laws often raise the same discussion.
How much should society infringe upon a person’s individual liberties? Do people have the right to make decisions that may be deemed unsafe to others?
Fortunately, most of us don’t have to struggle with this question on a regular basis. For people with intellectual disabilities, this struggle can occur every day.
When people with intellectual disabilities receive support from governmental programs, they enter a system whose main purpose is to support the health and safety of the people it serves. In most cases, this is a worthy pursuit. Some people with intellectual disabilities rely wholly on others to make decisions to ensure that their basic needs are met. The support of caregivers enables them to have healthy meals, maintain personal hygiene and receive necessary medical treatment.
Regardless of a person’s intellectual capacity, all people have the right to make choices and exert control over their lives. Yet when someone’s life choices are a risk to his or her health and safety, society’s role as protector comes into conflict with individual liberties.
Disabilities advocates use the phrase “dignity of risk” to describe this paradox. The idea is that if people have the right to make choices, they have the right to make bad choices. After all, the way we learn to make better choices is to live with the consequences.
The complication is the tension between the commitment of caregivers to keep people safe and healthy (often called duty of care) and the rights of people with disabilities to make decisions for themselves.
Programs that provide services for people with intellectual disabilities constantly consider the notion of dignity of risk. We want to treat people with intellectual disabilities with dignity and honor their capabilities. We also must weigh the risks of choices that could cause harm.
A crucial component of choice is the ability to understand the risks and benefits. People with intellectual disabilities are often able to understand the consequences of their choices, but they may need extra support to come to that understanding. Decisions that have a high risk of harm may need to be made with a team of family, friends and caregivers who can help the person make the best decision possible.
None of the team decision-making process relieves paid caregivers of their responsibility to prevent injury or illness. Yet, it is also important to remember that just as we all want the freedom to live a life outside a protective bubble, people with intellectual disabilities want to experience a fulfilling life. And, as we all know, even with a seat belt on, life has its risks.
Tara Kiene is director of case management with Community Connections Inc.