Risk, vulnerability and uncertainty

In the Introduction, we outlined a number of features of late-modernsocieties – uncertainty, complexity and abstractness in particular– which may serve to heighten experiences of anxiety andvulnerability (Wilkinson, 2001) and, moreover, exacerbate challenges toindividual considerations of action and decision-making (Beck, 1992). Wenoted the existence of various processes, connected to the individualisationof society, by which the futures of individual actors are seemingly morecontingent on their own decisions than was previously the case (egpension-planning; see Jones et al, 2010), but where the range of informationand expert support is also perceived as more contested, constructed andpotentially fallible than before. The existence of decision-relatedcontingencies amidst uncertainty points towards the salience ofrisk within this context – both for individualsas they seek to make decisions in the everyday (Zinn, 2008a) and forpolicymakers as they attempt to manage institutions in a legitimate,effective and economically viable manner (Kemshall, 2002).

Risk involves the contingency of future outcomes – often referring tonegative outcomes, though this is not necessarily so – in relation tothe probability that a particular outcome will result aswell as the magnitude of its impact. In this sense, risk isa lens for considering eventualities within an uncertain future and a modeof planning or acting in relation to these. In its narrowest sense,considerations of risk are decidedly calculative ones, involving therefinement of technologies that seek to gauge the probability of certainevents (a patient failing to cooperate with psychiatric treatment) and themagnitude of the consequences of this (for the patient and others in thecontext). However, a number of social scientists, for example Mary Douglas(1992), alongside academics working within mental health services (egSzmukler, 2003), emphasise various broader considerations that are inherentto how we think about risk. For when we consider future outcomes, as theseare attributed to individual decisions (Luhmann, 1993), we are not justthinking mathematically. Rather we are attaching values tothe perceived outcomes, and this process renders risk a thoroughly politicaland moral phenomenon as much as a calculative one (Douglas, 1992; Szmukler,2003).

Yet, while risk is never, and can never be, purelycalculative, it does nonetheless involve an approach to the future thatinvokes probabilistic thinking and an assessment of action in the light ofthis.