The case of the lady who risked exploding: A study of multiple consequences and contested values

This paper explores the role of value judgements in personal risk management through an in-depth case study involving a woman's treatment for anal cancer. Julia (pseudonym) agreed to have her pre-treatment medical consultation recorded, and participated in two subsequent interviews. Delving into a single case makes it possible to understand why an individual makes decisions in relation to the overall nexus of risks and benefits which they identify even though their choices may seem irrational to others. According to the colorectal nurse research interviewer, Julia ‘risked exploding’ as a result of ‘absconding’ (Julia's term) from hospital in order to have sex shortly after undergoing surgery. Although not to be interpreted literally, the above phrase encapsulates Julia’s risk blindness from a clinical perspective. The article will address the question of how one person came to put herself at unnecessary risk. The question will be considered in relation to non-communication about the interconnected web of issues which troubled Julia, including cosmology, mortality, being left with an unclean, leaky body, loss of economic viability and harm to family members and to close relationships. This analytical framework complements the more usual one in which attitudes towards a particular risk object are compared across cases. The article makes a contribution, within the limits of a single case study, to advancing knowledge about the neglected topic of individual risk consciousness. It will be argued that, in the absence of such analysis, personal decision-making about risks cannot be fully understood, appropriate advice given or sensitive policies developed.