Abstract
Sexual consent has become an increasingly challenging and controversial topic for on-call physicians and many other clinicians as they navigate issues specific to patients with major neurocognitive disorders (formerly dementia). One of the reasons that assessing decisional capacity to consent to sexual activity may be difficult is that there are a host of clinical, ethical, and legal considerations that arise and are difficult to contemplate concurrently. In this chapter, we group some of these topics together as they are relevant to clinicians working in various institutional settings (e.g., nursing homes, medical and psychiatric inpatient units). From a risk management perspective, on-call physicians should be familiar with the local policies pertaining to sexual behavior of patients. Hospitals and other healthcare organizations may want to consider developing or revisiting their policies to guide on-call physicians in handling issues around consenting to sexual activity for patients with impaired decision-making capacity.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Chow ES, Hategan A, Bourgeois JA. When it’s time for ‘the talk’: sexuality and your geriatric patient. Curr Psychiatry. 2015;14(5):13, 14, 16–19, 29, 30.
Tang SL. When “yes” might mean “no”: standardizing state criteria to evaluate the capacity to consent to sexual activity for elderly with neurocognitive disorders. Elder Law J. 2015;22(2):450–90.
McSherry B, Somerville MA. Sexual activity among institutionalized persons in need of special care. Windsor Yearbook Access Justice. 1998;16:90–131.
Breland L. Lost libido, or just forgotten? The legal and social influences on sexual activity in long-term care. Law Psychol Rev. 2014;38:177–92.
Hill E. We’ll always have shady pines: surrogate decision-making tools for preserving sexual autonomy in elderly nursing home residents. William Mary J Women Law. 2014;20:469–90.
Dein K, Williams PS. Relationships between residents in secure psychiatric units: are safety and sensitivity really incompatible? Pyschiatry Bull. 2008;32:284–7.
Kennedy CH. Legal and psychological implications in the assessment of sexual consent in the cognitively impaired population. Assessment. 2003;10(4):352–8.
Humphreys TP, Brousseau MM. The sexual consent scale-revised: development, reliability, and preliminary validity. J Sex Res. 2010;47(5):420–8.
Perlin M, Lynch AJ. “All his sexless patients”: persons with mental disabilities and the competence to have sex. Wash Law Rev. 2014;89:257–300.
Murphy GH, O’Callaghan A. Capacity of adults with intellectual disabilities to consent to sexual relationships. Psychol Med. 2004;34(7):1347–57.
Lyden M. Assessment of sexual consent capacity. Sex Disabil. 2007;25(1):3–20.
Spady A. The sexual freedom of eve: a recommendation for contraceptive sterilization legislation in the Canadian post Re Eve context. Windsor Rev Legal Soc Issues. 2008;25:33–67.
Lindsay JR. The need for more specific legislation in sexual consent capacity assessments for nursing home residents. J Leg Med. 2010;31(3):303–23.
Keitner G, Grof P. Sexual and emotional intimacy between psychiatric inpatients: formulating a policy. Hosp Community Psychiatry. 1981;32(3):188–93.
Bartlett P, Mantovani N, Cratsley K, Dillon C, Eastman N. ‘You may kiss the bride, but you may not open your mouth when you do so’: policies concerning sex, marriage and relationships in English forensic psychiatric facilities. Liverpool Law Rev. 2010;31:155–76.
UN convention on human rights for persons with disabilities. http://www.un.org/disabilities/convention/conventionfull.shtml. Accessed 21 Feb 2016.
Macgregor-Morris R, Ewbank J, Birmingham L. Potential impact of the Human Rights Act on psychiatric practice: the best of British values? BMJ. 2001;322(7290):848–50.
Perlin M. “Everybody is making love/or else expecting rain”: considering the sexual autonomy rights of persons institutionalized because of mental disability in forensic hospitals and in Asia. Wash Law Rev. 2008;83:481–512.
Mackenzie R, Watts J. Capacity to consent to sex reframed: IM, TZ (no 2), the need for an evidence-based model of sexual decision-making and socio-sexual competence. Int J Law Psychiatry. 2015;40:50–9.
Curtice M, Mayo J, Crocombe J. Consent and sex in vulnerable adults: a review of case law. Br J Learn Disabil. 2012;41:280–7.
Herring J, Wall J. Capacity to consent to sex. Med Law Rev. 2014;22(4):620–30.
Kennedy CH, Niederbuhl J. Establishing criteria for sexual consent capacity. Am J Ment Retard. 2001;106(6):503–10.
Hategan A, Bougeois JA, Parthasarathi U, Ambrosini DL. Counseling geriatric patients about opportunity and risk when “digital dating”. Curr Psychiatry. 2016 (in press).
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Ambrosini, D.L., Hategan, A., Bourgeois, J.A. (2016). The Sexual Consent and Patients with Major Neurocognitive Disorders. In: Hategan, A., Bourgeois, J., Hirsch, C. (eds) On-Call Geriatric Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-30346-8_15
Download citation
DOI: https://doi.org/10.1007/978-3-319-30346-8_15
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-30344-4
Online ISBN: 978-3-319-30346-8
eBook Packages: MedicineMedicine (R0)