THE QUESTION
The question--What can we count on to make and keep people safe?--
frames an important perspective on the continuing work of building
communities that offer people with developmental disabilities full
and dignified lives. It arises from a realization of the
vulnerability to neglect, abuse, and mistreatment risked by people
who require substantial, long-term assistance to take and keep
their rightful place as citizens. It is shaped by a sober
recognition of the shortcomings of unregulated relationships
between people with disabilities and their caretakers and the
limitations and ironic effects of systematic efforts to keep people
safe through professional, bureaucratic methods. Left to their own
services, a frightening number of care providers act inhumanly.
But increasing investments in formal means to regulate these
relationships don't proportionally increase confidence in people's
safety. Indeed formal systems seem to weaken the spirit of
commitment necessary for caring relationships to thrive.
Discussion is animated by acknowledgment of the desirability and
necessity of action to increase people's safety of both
strengthening the ties of community and making necessary assistance
more relevant and effective.
Efforts to ensure the safety of people who rely on services have an
instructive history. Many of today's approaches to improving
quality through policy, training, hands-on management, and external
monitoring would be familiar to nineteenth century asylum keepers.
Then, as now, their insufficiency raises a troubling issue. Can it
be that the very design of well-managed settings that meet every
need frustrates our attempts to embody our good intentions? Could
it be that the community services we have carefully developed share
too many characteristics with earlier, now discredited approaches?
And if so, must people with developmental disabilities accept the
built-in limits of total environments as the best available
compromise in a dangerous world? What strategies offer ways to
constructively engage these questions?
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