ELEVEN YEARS AGO I visited Washington state on a fellowship to better understand its adult protection system. I took with me some real-life scenarios and was interested to find out how services there would respond to similar situations. One of these scenarios involved a man I referred to as Andrew, who was in his fifties and had an intellectual disability. He was living alone following the death of his mother, who had been his carer. Andrew was living in a state of severe domestic mess and had a serious though treatable medical condition, but he was rejecting any offers of assistance at his front door. 

After being ushered into the Adult Protective Services’ secure offices in Washington, I asked their representatives how they would respond to Andrew’s situation. What would they do? Nothing, I was told; it was his human right to reject services.