Invited commentary: Anatomy of risk

Abstract

The theoretical notion of risk is sweeping all before it. Politicians, government planners, scientists and doctors, including psychiatrists, are having to confront a more formalised concept of risk. This is not to say that our awareness, as human beings, of notions of risk has hitherto been largely negligible. However, there is an evident contemporary preoccupation with risk, its assessment and management, which signals society's unwillingness to tolerate or bear anything but the most minimal possibility of adverse outcomes. There are competing definitions and concepts of risk which complicate discussions between experts and the lay public. For example, Thompson (1990) distinguishes between ‘real’ risk, ‘observed’ risk, and ‘perceived’ risk. Real risk is thought to reflect how things stand in the real world. That is, it is a term which refers to actual risk, the actual negative consequences which exist, be they random or otherwise. Whereas observed risk is our evaluation of negative consequences based upon a theoretical model of the physical world. This is further distinguished from perceived risk which is conceived of as being the estimate of real risk in the absence of a theoretical model of the world. The distinction which is being drawn is a subtle one but it is an attempt to capture the idea that our perception of risk is judgmental in nature and does not necessarily correspond with objective reality. The underlying assumption, that our subjective evaluation of risk may not coincide with the true nature of things, is one that psychiatrists are familiar with. The lay perception of the risk that psychiatric patients pose to the public is, at the least, an exaggeration of the objective facts. However, the observed risk, that is the risk calculated by experts that psychiatric patients pose to the public may not be an accurate reflection of the actual risk posed by psychiatric patients.