Wednesday, August 23, 2006

Risks and benefits of stair lift use

Example: weighing up risks and benefits in assisting a client in relation to stairlift use. A social work service occupational therapist [OT] refuses on safety grounds to recommend a stairlift for a disabled woman, instead recommending a through-floor lift. She judges that the risk of using the stairlift is simply too great.

The woman does not want the through-floor lift and manages to obtain her own second-hand stairlift. Some months later she is using the stairlift several times a day and gets back in touch with the OT and asks whether she could visit and arrange the installation of rails at the top and bottom of the stairs to make transfers safer. The OT visits, concludes that the stairlift use is just as unsafe, recommends that the woman should not use it - but decides nevertheless to assist with the rails [even though one of her colleagues advises her against it, because it would be `collusion' with an unsafe practice].

The OT would need to reason out her decision in terms of risks and benefits to the client; for example, provision of the rails might reduce the risk inherent in what the woman was anyway doing several times a day. Thus the therapist would be making clear that far from introducing, creating or encouraging the taking of unacceptable risks, she was in fact reducing the risks that the woman was anyway determined to take. Furthermore, so long as the OT carefully documents her reasoning and that she has in any event advised the woman not to use the stairlift - then whether or not the OT assists with the rails, a court is likely to view the woman, rather than the OT, as the overall cause of any accident in respect of the stairlift.