The work answers the question, how can health risk be comprehensively managed when societies are in unfavorable conditions to develop dignified lives? For this, the author carries out a theoretical analysis of the notions of risk, from the perspectives of Beck and Luhmann; identifies factors that can favor or disadvantage health risk management; explores the perspectives of Sen and Nussbaum, about the conditions, capacities and operations that are necessary to achieve risk prevention in democratic societies; and, based on the deliberative bioethics of Guttman and Thompson, shows the possibility of managing health risk through a “reflective balance” between the norms established in health policies and the material conditions and real capacities of people.