Taking risks is a part of everyday living, and a contributor to our sense of dignity. Yet as people age, or develop cognitive, mental or physical impairments, opportunities to take risks can diminish. A life without risks can erode a person’s dignity. The purpose of this narrative review was to explore the application of the concepts of the Dignity of Risk and Therapeutic Risk in literature pertaining to community-based support for people living with a range of physical, mental and/or cognitive constraints. We aimed to understand how these concepts are conceptualised, articulated, negotiated and enacted in theory and practice. During a period from October 2017 to January 2018, seven databases were searched for relevant literature. Thematic analysis techniques were applied to synthesise the data from 47 academic papers that met the inclusion criteria. Our analysis demonstrates persistent ethical tensions. There is widespread support for the application of both concepts across a range of discourses, but a number of long-standing ethical considerations pertaining to risk, safety, rights and negotiation persist. We argue that the way forward is to resist the temptation to simplify the issues, but instead to accept and accommodate ethical complexities while implementing evidence-informed solutions such as intersubjective risk negotiation strategies, community-centred relational approaches to decision-making, and education and training in communication skills and the positive potential of risk. Future research to examine the impacts of the implementation of these strategies would be timely, beneficial and welcome.

冒险是日常生活的一部分，也是我们尊严感的重要因素。然而，随着人们的年龄增长，或出现认知，心理或身体上的障碍，冒险的机会会减少。没有风险的生活会侵蚀人的尊严。这篇叙述性综述的目的是探讨风险尊严和治疗风险的概念在文献中的应用，这些文献涉及基于社区的对有一系列身体，精神和/或认知障碍的人们的支持。我们旨在了解如何在理论和实践中对这些概念进行概念化，表达，协商和制定。在2017年10月至2018年1月的期间，共检索了七个数据库以查找相关文献。应用主题分析技术对来自符合纳入标准的47篇学术论文的数据进行综合。我们的分析证明了持续存在的道德紧张。这两种概念在各种论述中的应用得到了广泛的支持，但是与风险，安全，权利和谈判有关的许多长期道德考虑仍然存在。我们认为，前进的道路是抵制简化问题的诱惑，而要接受并适应道德上的复杂性，同时实施以证据为依据的解决方案，例如主体间风险谈判策略，以社区为中心的关系决策方法以及教育和培训。交流技巧培训和潜在的正风险。