Perspect Biol Med. 2022;65(2):262-273. doi: 10.1353/pbm.2022.0022.
Historically, people with intellectual/developmental disabilities (IDD) lived in institutions with little contact with the community. Having a label of "mental retardation" meant they were incapable of living and working outside of the institution. These individuals were protected from risk and harms and had little input into how they lived their lives. Perske (1972) challenged the idea that persons with IDD necessarily had to be protected from the harms one faces in daily life. He championed the principle of "dignity of risk," respecting their right to weigh risks and harms of their choices. Over time, federal, state, and local agencies embraced the idea that people with IDD should be integrated into communities and receive supports so they may live their lives to the fullest. This article discusses how a community agency worked with their clients with IDD to balance their personal liberties with acceptable risks as they live and work in the community. Approaches such as the use of a Risk Committee or the empowerment of direct care workers in assessing risks are described through case illustrations.
从历史上看,智障人士(IDD)生活在与社区几乎没有联系的机构中。被贴上“智力迟钝”的标签意味着他们无法在机构之外生活和工作。这些人受到保护,免受风险和伤害的影响,对自己的生活方式几乎没有任何发言权。Perske(1972)质疑智障人士必然需要受到保护,以免在日常生活中受到伤害的观点。他倡导“风险尊严”原则,尊重他们权衡风险和选择后果的权利。随着时间的推移,联邦、州和地方机构都接受了这样一种理念,即智障人士应该融入社区,并获得支持,以便他们能够充分地生活。本文讨论了一个社区机构如何与他们的智障客户合作,在他们在社区中生活和工作时,平衡他们的个人自由和可接受的风险。通过案例说明描述了使用风险委员会或授权直接护理人员评估风险等方法。