Let people in care choose risky ways of living, and do not hold the care facility legally responsible for those choices
In short
- People who receive care can choose how they live, as long as they understand the risks.
- A facility is not held responsible for injuries that come from a risk the person chose.
- Family members cannot cancel, on the person's behalf, a way of living the person chose.
- Rules that tie down every resident the same way to prevent accidents are ended.
If this comes true
A ninety-year-old woman knows she might fall, yet she walks alone in the facility garden every morning and checks the tomatoes she planted, which swell a little more each day.
Perhaps
A facility short on staff might hide behind papers saying "the person chose this" and watch residents less, and a man who collapsed in a hallway at night might not be found until morning.
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The proposal in detail
This covers care facilities where older people and people with disabilities live, and care given in people's homes. People who receive care can choose ways of living that involve risk, such as walking alone, going out, eating a favorite food that might get stuck in the throat, drinking alcohol, or staying up late. The facility explains the risk in a way the person can understand, and records what the person chose and what watching over the facility will provide. People who need help making decisions are still supported so that the choice is theirs, and only when their wishes truly cannot be confirmed does anyone estimate them from the person's past words and way of life. Family members can share their opinions, but they cannot cancel a choice the person made. For injuries and accidents that come from a choice recorded this way, the facility is not held legally responsible, as long as it has given the explanation, kept the record, and provided the watching over it promised. On the other hand, a facility that urges a person toward a dangerous choice to make up for a lack of staff, or that neglects the watching over it promised, takes on heavier responsibility than before. The oversight agency adds to its evaluation of facilities not only how few accidents there are but also how well residents are able to choose for themselves, and it does not allow rules such as banning everyone from going out or cutting all meals into tiny pieces unless each person's need for it is shown.
BenefitsPeople can spend the last part of life in their own way
When a facility is not held responsible for risks the person chose, it no longer has to turn down residents' wishes out of fear of what might happen. The joys of daily life and the sense of being oneself come back, such as walks, outings, favorite foods, and quiet moments at night. Days in which only the body is kept safe and everything else is decided for you take away, for many people, the very will to live. When there are still things a person can decide, they can keep their pride even as the body weakens, and it is easier to stay connected with the people around them. Continuing to walk keeps the body strong and can even delay becoming bedridden. Because family members cannot cancel the person's choice, the worries of a relative who lives far away no longer come before the wishes of the person living each day. By adding how well residents can choose to the evaluation of facilities, facilities that adapt to each person are rated higher than those that tie everyone down the same way. The decision between safety and freedom is returned from the people who protect to the person who is living.
DrawbacksWe would have to accept injuries and deaths that could have been prevented
Even though the person chose it, more people will certainly break bones in falls or choke on food, and some of them will lose their lives. For a family, it is hard to accept that when a parent is injured or dies in a facility, no one can be held responsible because the parent chose it. This system could also become an excuse for a short-staffed facility to cut back on watching over residents. Even if heavier responsibility is set, it is hard to tell afterward whether a resident chose on their own or was quietly pushed toward it by the facility. Some people hold back their true feelings out of consideration for the facility, and others deliberately choose a dangerous path because they think of the burden on their family. For people whose judgment wavers, such as those with dementia, it becomes even harder to decide which words count as the person's choice. If someone says they want to walk yesterday and are afraid today, which wish should be followed? A wrong judgment would mean that, in the name of self-determination, someone who should have been protected is abandoned.
Learn the background
When people grow old or have a disability and start receiving care, many suddenly lose the power to decide how they live. They are stopped from walking because they might fall, kept from favorite foods because they might choke, and the doors to the outside are locked. These rules do not come from meanness. When an accident happens in a facility, families blame it, courts hold it responsible, and the oversight agency looks at it harshly. For a facility, preventing injuries to residents is also a way of protecting itself. As a result, residents' joys and pride are chipped away little by little in the name of safety. No matter how much a resident says, "I want to walk, even if I fall," the facility bears the responsibility, so those words do not count. The idea that people decide with support is spreading, but as long as the system for deciding who bears the results of those decisions does not change, facilities cannot accept a person's choice. Caught between freedom and safety, the present system has always put its weight on the side of safety, without listening to the person's own voice.
Choose them ready to accept their drawbacks too (up to 5)
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This proposal was written in Japanese by AI (claude-opus-5-5, policy version 2026-10-23b) and translated by AI (claude-sonnet-5-5). Nobody has checked the facts. Read the original (日本語) How the AI writes