Dignity of Risk or Redistribution of Responsibility? Re‐Thinking Ethics, Autonomy and Nursing Practice in Contemporary Aged Care.

The principle of dignity of risk (DoR) has become a cornerstone of contemporary aged care reform. DoR is ethically framed as an extension of autonomy and person‐centred care. While widely considered in policy and professional discourse, DoR is often treated as a self‐evident ethical good, with limit...

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Publicado en:Nursing Inquiry Vol. 33; no. 3; pp. 1 - 7
Autor principal: Dzando, Gideon
Formato: Journal Article
Publicado: Wiley-Blackwell Jul2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2026
      vid: 33
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        195655263
        10.1111/nin.70108
        195655263
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        atl: Dignity of Risk or Redistribution of Responsibility? Re‐Thinking Ethics, Autonomy and Nursing Practice in Contemporary Aged Care.
      aug:
        au: Dzando, Gideon
        affil: Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide South Australia,, Australia
      sug:
        subj:
          Gerontologic Nursing Ethical Issues
          Autonomy
          Decision Making, Ethical
          Patient Centered Care
          Ethics, Nursing
          Human Dignity
          Nursing Practice
          Health Policy
          Relational Autonomy
          Audit
          Organizational Culture
          Family Role
          Accountability
          Technology, Medical
          Residential Care
          Documentation
          Risk Assessment
          Nursing Care Plans
          Incident Reports
      ab: The principle of dignity of risk (DoR) has become a cornerstone of contemporary aged care reform. DoR is ethically framed as an extension of autonomy and person‐centred care. While widely considered in policy and professional discourse, DoR is often treated as a self‐evident ethical good, with limited critical attention to how it is operationalised within regulated care systems. This paper offers a critical ethical analysis of DoR as enacted in contemporary aged care, arguing that it functions not merely as a moral principle but as a moral technology that redistributes responsibility, liability and ethical burden across residents, nurses, families, organisations and regulatory structures. Drawing on nursing ethics, relational autonomy and regulatory theory, the paper examines how documentation practices, audit cultures and family involvement reconstitute nurses as ethical risk brokers who must legitimise resident choice while remaining accountable for adverse outcomes. Rather than rejecting DoR, the paper reframes it as a form of collective ethical responsibility which requires organisational, regulatory and moral support for nurses beyond individualised accountability. This analysis highlights the need to move from symbolic invocations of autonomy toward ethically sustainable practices that recognise the relational and institutional labour underpinning DoR in everyday nursing practice.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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