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 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.