The following is based on a talk given to the Adult Support and Protection in Supported Settings conference (ASPIRE) a couple of weeks ago.
Every morning, somewhere in Scotland, a hand is held out.
It may be on a tenement stairwell where the paint is peeling and the light is poor. It may be at a cottage door, wind pressing against the frame. It may be across a kitchen table where the kettle has boiled twice already, because the conversation has taken longer than expected. That hand belongs to a social worker, a district nurse, a support worker, a care professional of one kind or another.
It is not a hand extended to seize control.
It is a hand offered to steady.
To accompany.
To share risk.
This is where adult protection truly lives. Not first in statute or guidance, important though these are, but in these ordinary, human moments where voice and safety pull against one another, and where the task is not to choose between them, but to hold them together.
The tension we live with
Much of our public language still frames safeguarding as a contest: autonomy on one side, protection on the other. We talk as though we must sacrifice one to secure the other. Yet anyone who has practised in adult protection knows that this framing is false.
Safety achieved at the cost of voice is not safety. It is containment.
Autonomy asserted without regard to real harm is not freedom. It is abandonment.
The real work, the hard work, takes place in the space between.
It is there, in that narrow, uncomfortable space, that practitioners reason, hesitate, listen again, and sometimes carry the weight of decisions that will never feel entirely clean. This is not technical work alone. It is moral labour, undertaken daily and often invisibly.
Scotland’s adult protection framework is, in international terms, strong. The Adult Support and Protection (Scotland) Act 2007, the Adults with Incapacity (Scotland) Act 2000, and the Mental Health (Care and Treatment) (Scotland) Act 2003 all encode a careful balance. They do not invite us to trade liberty for safety. They require us to secure safety through autonomy, participation and proportionality.
The principles are clear: benefit, least restriction, respect for wishes, supported decision‑making, review. PANEL- Participation, Accountability, Non‑discrimination, Empowerment and Legality- sits as a human rights model beneath this as a deceptively simple but profoundly demanding lens.
Yet law, on its own, does not do the work for us. It gives us scaffolding, not shelter.
Recent joint inspections of adult support and protection across Scotland have been honest about this. Multi‑agency working has improved. Commitment is evident. But variability remains, particularly in chronologies, in risk formulation, and in how consistently lived experience is captured and used to shape decisions. Where voice is poorly recorded, it is too easily overridden. Where proportionality is not clearly reasoned, restriction can quietly become routine rather than exceptional.
This is not about blaming practice. It is about recognising that rights‑based safeguarding requires constant attention. It is never finished. It must be renewed in every assessment, every case conference, every supervision conversation.
The quiet danger of urgency
One of the greatest threats to rights‑based practice is urgency.
Fear presses. Risk escalates. Time feels short. And in those moments, the temptation is to act quickly; to “do something” even if what is done narrows a life more than is truly necessary.
International human rights research repeatedly shows that when decision‑making collapses into speed alone, proportionality suffers. The most effective safeguard against unnecessary restriction is not abstract balancing, but disciplined insistence on the question: Is there a less restrictive way? Where that question is taken seriously, rights are more robustly protected and outcomes improve.
This is why proportionality is not a bureaucratic hurdle. It is an ethical brake.
To pause is not to neglect risk.
To slow down is not to be naïve.
Often, it is the most protective act available.
Beyond Scotland, the same tensions are being named with increasing clarity.
In 2024, the UN Independent Expert on the human rights of older persons, Claudia Mahler, published a major report on legal capacity and informed consent. It describes a global pattern in which consent in later life becomes procedural rather than meaningful; a nod, a signature, an acquiescence shaped by fatigue, pain or power imbalance. Capacity, too often, is assumed to be lost rather than actively supported.
The Expert’s message is disarmingly simple: presume capacity; support communication; treat consent as a process, not an event.
This resonates deeply with everyday practice. The unhurried cup of tea before the difficult conversation. The hearing aid battery replaced. The quieter room. The advocate who waits in silence until the person finds their words. These are not soft extras. They are the practical means by which autonomy is made real.
At the same time, something historic is unfolding. In April 2025, after fourteen years of evidence‑gathering and advocacy, the UN Human Rights Council established an intergovernmental working group to draft a legally binding convention on the rights of older persons. The conclusion was stark: existing international protections leave older people exposed to discrimination, abuse and the erosion of voice, particularly in health and care settings.
This is more than diplomacy. It is a signal, to governments, to inspectors, to practitioners, that age must never be treated as a proxy for incapacity, and that protection must never be used as cover for exclusion.
Even before a convention is finalised, its normative pull matters. Expectations shift. Scrutiny sharpens. What once passed unquestioned will increasingly require justification.
Most restrictions of liberty do not arrive dramatically. They arrive softly.
“She’s 89—she won’t manage.”
“He’d be safer if we just…”
“At her age, is it really worth…?”
Ageism rarely announces itself. It seeps into thresholds, hastens moves, narrows imagined futures. The UN’s work on older persons’ rights is explicit that these assumptions are not benign. They are discriminatory, and they materially increase the risk of harm rather than reduce it.
Safeguarding done badly shrinks a life.
Safeguarding done well creates the conditions in which life can still be lived.
The emotional cost of holding the balance
What is often missing from our systems is acknowledgement of the emotional labour involved in holding liberty and safety together.
To protect without overpowering.
To respect choice while living with uncertainty.
To know that whatever decision is taken, it will leave a residue.
This work demands professional courage. It asks practitioners to tolerate ambiguity, to justify restraint when necessary, and to step back when fear would rather tighten the grip. It also asks organisations and leaders to create cultures where thoughtfulness is protected, not penalised.
Holding the hand, not tightening the grip
What does this mean, practically, for adult protection?
It means treating advocacy as a default where decisions carry significant restriction, not as an optional add‑on.
It means writing chronologies that tell a causal story, not merely a timeline.
It means recording capacity as specific, supported and time‑bound, never as a fixed label.
It means making PANEL the structure of our conversations, not just our paperwork.
Above all, it means remaining present, especially when fear is loud.
In the end, adult protection is not about the subtraction of freedom. It is about companionship in risk. About walking with someone far enough that they remain themselves, and close enough that harm does not have the final word.
To hold liberty and safety in one hand is not easy. But it is the work.
And every morning, across Scotland, it is being done, quietly, imperfectly, thoughtfully, and with courage.
Donald Macaskill
Photo by Nathan Dumlao on Unsplash
