Dementia and Concurrent Consent to Sexual Relations

Author:

Director Samuel

Abstract

AbstractPhilosophers have become newly interested in the ethics of sex. One promising feature of this new discussion is that it has been broadening our moral lens to include individuals whose sexual interests have historically been denied or ignored. One such group is the elderly. Contrary to popular belief, many elderly people want to have sex and see it as a regular part of their lives. If society harbors ignorance about or prejudice against elderly sexuality, it harbors stronger views against the sexual expression of elderly people with dementia. People with dementia are often prohibited by nursing‐home staff, sometimes in extreme ways, from having sex with their partners. This prohibition is at least partly motivated by the goal of protecting the vulnerable. However, cutting people with dementia off from sex has negative health effects and is a needless restriction of their autonomy. In this article, I argue that the expanding moral lens in sexual ethics should include the sexual expression of elderly individuals with dementia and that their sexual expression should be respected. Specifically, I argue that many people with dementia are competent to consent to sexual activity with their long‐term partners.

Publisher

Wiley

Subject

Health Policy,Philosophy,Issues, ethics and legal aspects,Health (social science),Industrial and Manufacturing Engineering,Environmental Engineering

Reference41 articles.

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2. This definition of an immediate-jeopardy violation comes from the Centers of Medicaid and Medicare Services’ guidance specifically appendix Q “Core Guidelines for Determining Immediate Jeopardy ” in State Operations Manual issued March 6 2019 https://www.cms.gov/Regulations-and-guidance/Guidance/Manuals/downloads/som107ap_q_immedjeopardy.pdf p.1. The citation in the Neighbors case was for a violation of 42 C.F.R. 488.301 which states that a facility must have “a level of compliance with the requirements of participation such that any identified deficiencies pose no greater risk to resident health or safety than the potential for causing minimal harm.”

3. Neighbors Rehabilitation Center LLC v. United States Department of Health and Human Services Departmental Appeals Board and Centers for Medicare and Medicaid Services 18-2147 (7th Cir. 2018)

4. Centers for Medicare and Medicaid Services "Revisions to Appendix Q Guidance on Immediate Jeopardy " March 5 2019 athttps://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/QSO19-09-ALL p.6.

5. A Study of Sexuality and Health among Older Adults in the United States

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