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Health Care Ethics and Law

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Health Care Ethics and Law Implications for Staff: Sexuality of People with Learning Disabilities Like everyone else people with learning disabilities have sexual feelings and a right to express them (Brown and Benson 1995). Carers will be closely involved with people's relationships, providing protection from abuse and exploitation. This presentation will look at the laws and ethical/moral implications for practice. Here is a brief historical overview of how the sexuality of people with learning disabilities has become an ethical and legal headache for staff. Segregation into large long stay hospitals and colonies was seen as away to prevent learning disabled people from having children through close supervision. Another motive was the belief that the public had the right to be protected from inappropriate sexual behaviours committed by those who could not act responsibly (Robbins 1990). Since the implementation of the NHS and Community Care Act 1990 the issue of the sexuality of people with a learning disability has come to the attention of care workers and the general public. In addition, there is an awareness, through concepts such as normalisation and empowerment that people with a learning disability have a right to express their sexuality. Craft (1994) comments this right should not be at the mercy of the individual sexual attitudes of different care givers. It is now recognised that in moving away from 'overprotecting' people with a learning disability through empowerment, issues of risk-taking and protection have had to be considered. ...read more.


Even with consent would it be ethically correct to teach masturbation with actual physical contact? Staff would need to consider the need, appropriateness, teaching methods available, and whether or not their actions could be viewed as abusive. Issues that may provoke legal action in relation to indecent assault, include the teaching of masturbation outside the context of a personal and social relationships programme or for the prurient interests of members of staff, helping clients with personal hygiene for prurient reasons, or where a female member of staff is having a sexual relationship with a 'defective' man. This is an offence because she would have to indecently touch him in the course of having sex, and being a 'defective' he by law is not able to consent. Care staff could be further restricted from permitting the continuation of a valuable sexual relationship by Section 27 of the Sexual Offences Act 1956. This has a wide range of possible offenders, and may result in owners, occupiers or care staff who are left in 'control' of residential premises, who endorse or rather who do not prohibit sexual relations of those deemed 'defective', being liable to prosecution (Evans and Rodgers 2000). As mentioned previously ethical problems also exist when dealing with sexuality in learning disabilities. For instance 'What is consent?' Should we assume that an understanding of the sexual act can demonstrate consent, or should we adopt the belief that only women with learning disabilities who show an understanding of the significance of sexual intercourse and its implications will be able to consent? ...read more.


However people with severe learning disabilities, referred to as 'defectives' in law, are deemed not to be able to give their consent to enter into sexual relationships and so are protected by the law (Brown and Benson 1995). Look at the following acts of parliament: - Section 128 of the Mental Health Act 1959 Section 1 of the Sexual Offences Act 1967 Section 127 of the Mental Health Act 1983 Sections 14 & 15 of the Sexual Offences Act Section 27 of the Sexual Offences Act 1956 There are many ethical problems for staff dealing with the sexuality of their clients. Robbins (1990) comments that staff attitudes are generally subjective and value laden, to make a difference to the lives of some of our clients we must put their needs before our own personal and moral judgements. Problems can arise due to religion, personal moral standards and views, and lack of training. Implications for Practice Implications for practice include the need for better self-awareness as you will be dealing with issues embarrassing to yourself and the client. Always consult colleagues if you are not sure about certain relationships, as there are possible repercussions to yourself and clients in aiding an unlawful sexual relationship or abusive one. Conclusion To deny a person's sexuality is to deny part of his or her personhood, and to deny that a person with learning disabilities is a sexual being is treating them less than a whole person (Fairbairn 2002). ...read more.

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