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RACK may be seen as focusing primarily upon awareness and informed consent, rather than accepted safe practices. The consent and compliance for a sadomasochistic situation can be granted only by people who can judge the potential results.For their consent, they must have relevant information (extent to which the scene will go, potential risks, if a safeword will be used, what that is, and so on) at hand and the necessary mental capacity to judge.The terms "top" and "bottom" are also used: the top is the instigator of an action while the bottom is the receiver of the action.The two sets of terms are subtly different: for example, someone may choose to act as bottom to another person, for example, by being whipped, purely recreationally, without any implication of being psychologically dominated by them, or a submissive may be ordered to massage their dominant partner.The resulting consent and understanding is occasionally summarized in a written "contract", which is an agreement of what can and cannot take place.Use of the agreed safeword (or occasionally a "safe symbol" such as dropping a ball or ringing a bell, especially when speech is restricted) is seen by some as an explicit withdrawal of consent.For the medical condition in which pain/humiliation is required for sexual arousal and causes distress or impairment, see Sexual masochism disorder.

The fundamental principles for the exercise of BDSM require that it should be performed with the informed consent of all involved parties.

Advocates of RACK argue that SSC can hamper discussion of risk because no activity is truly "safe", and that discussion of even low-risk possibilities is necessary for truly informed consent.

They further argue that setting a discrete line between "safe" and "not-safe" activities ideologically denies consenting adults the right to evaluate risks vs rewards for themselves; that some adults will be drawn to certain activities regardless of the risk; and that BDSM play—particularly higher-risk play or edgeplay—should be treated with the same regard as extreme sports, with both respect and the demand that practitioners educate themselves and practice the higher-risk activities to decrease risk.

The precise definition of roles and self-identification is a common subject of debate within the community.

"BDSM" is an umbrella term for certain kinds of erotic behavior between consenting adults.

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