Choosing to Live with Harm? A Presentation of two Case Studies to Explore the Perspective of those who Experienced Adult Safeguarding Interventions

Abstract

Adult safeguarding often creates a tension for welfare practitioners between promoting an adult’s autonomy and their duty to try to protect them from harm. Literature highlights the dangers of adopting simplistic notions of autonomy and capacity in assessing whether someone may be choosing to live with harm. Yet very little has been published about how adults at risk and family members experience the tension between autonomy and protection: what choices do they think they have and why might they choose one above another? The article starts to address this gap by utilising an ethic of care to explore the experiences of an adult at risk; and then a family member where older people were being harmed within family relationships. These accounts were drawn from a Scottish qualitative adult safeguarding study. They highlight how choice, autonomy and capacity are interconnected concepts; and that they can be compromised by a range of personal, relational and environmental factors. In addition they demonstrate how practitioners can support or limit the choices open to adults at risk and their family members. The ensuing discussion summarises the implications for practice and considers how voices of experience might be better captured in the future.