The ‘messy middle’ with dignity of risk

What do you do when a participant wants to try something new and potentially risky, but their family says no and/or your staff are worried about the chance of serious harm?

This is the messy middle of NDIS service delivery, where the principles of duty of care and dignity of risk collide with real-world pressures. These are not just legal or compliance concepts. They shape daily frontline decisions, affect participants’ rights and wellbeing and determine whether providers build trust and long-term sustainability.

Why it matters now

Duty of care and dignity of risk sit at the heart of ethical NDIS practice, yet they are often misunderstood. Duty of care is a provider’s legal obligation to take reasonable steps to prevent harm. Dignity of risk is about respecting a person’s right to take risks, even when harm is possible. The challenge lies in striking a balance between the two in everyday service delivery.

As Rob Woolley explains in his article on the 10 myths of duty of care, there are a lot of common misconceptions in this space. For frontline staff, this plays out in everyday dilemmas: a participant wanting to spend grocery money on cigarettes, a family anxious about late-night walks or concerns about a new relationship. Providers need to navigate these scenarios against a backdrop of tighter plan budgets, more audits and family members (who might also be plan nominees or guardians) who are understandably focused on the safety of their loved one.

Getting this balance wrong can mean complaints, compliance breaches and, most importantly, undermining autonomy. Getting it right builds trust with participants and families, reduces incidents and creates a more confident workforce. It is not just about compliance, it is about delivering contemporary, rights-based practice that sustains organisations and supports genuine choice and control.

Supported decision-making and dignity of risk are interconnected

Genuine choice and control often rely on getting supporting decision-making right. During my time as a Policy Director at the Disability Royal Commission, I helped develop the next iteration of national principles for supported decision-making, building off the work of the Australian Law Reform Commission. These principles were developed to not only guide law reform, but also to have broad application across systems and contexts, including the NDIS.

The principles affirm that:

• all people with disability have an equal right to make decisions that affect their lives
• all people with disability must be presumed to have decision-making ability
• dignity of risk is essential to living life the way we choose.

For providers, this means dignity of risk is inseparable from supported decision-making. When staff face tricky situations, whether it is about relationships, money, or independence, the question is not “how do we stop this?” but “how do we support the person to make and act on their own decision safely enough?”

Bringing supported decision-making into duty of care shifts practice from protection to partnership. It helps staff back participants’ choices while managing risk in ways that build trust.

Practical tools for providers

Six-step guide

For our workshop on Balancing Risk and Rights: Duty of Care in Contemporary NDIS Practice, we have developed a Risk and Rights Decision Guide tool to help providers navigate these “grey areas” without defaulting to fear or guesswork. It doesn’t replace professional judgment, but it does give frontline workers and managers a framework to guide their approach. It offers six clear steps:

1. Start with the person as the decision-maker
2. Support understanding and informed choice
3. Identify the real risk and duty of care obligations
4. Manage, don’t eliminate, risk
5. Involve the right people, the right way
6. Document and communicate the decision-making process clearly

We take a closer look at how to use the Guide in the workshop, applying it to real-world scenarios.

Shifting culture

Frameworks are important, but good decisions also depend on culture. A rights-based approach to risk needs a shared mindset, language and leadership across the organisation.

• Mindset: Train staff to think “how can we make this safe enough?” instead of “how do we stop this?”.
• Language: Replace “we let them” with “we support them to”.
• Leadership: Model curiosity and problem-solving around risk and highlight examples of enabling risks and learning from mistakes that have led to positive outcomes for participants.

Building confidence in the grey zone

None of this is easy. Every provider faces these dilemmas and no policy or procedure can solve every scenario in advance. But with the right tools and culture, providers can support real choice and control without breaching their duty of care.

The six steps and cultural shifts outlined here are just a starting point. In our upcoming workshop, Balancing Risk and Rights: Duty of Care in Contemporary NDIS Practice, we will go deeper: applying the Decision Support Guide to real-world scenarios, unpacking common sticking points and exploring how leaders can embed a rights-based, risk-affirming approach across their organisation.

Because duty of care done well does not close doors; it opens them safely.