Althouse: "Sexuality shouldn't be categorized as a high-stakes decision..."

June 27, 2012

"Sexuality shouldn't be categorized as a high-stakes decision..."

"... like, say, a will or a major financial decision where you really need the capacity to consent to things... We're saying that sexuality is different and the way to establish consent should be different."

51 comments:

edutcher said...: According to The Blonde (who spent 5 years working Communicable Disease), it should.

Even though you won't get pregnant, she will tell you all the party favors of venereal disease aren't worth taking the risk.; 6/27/12, 9:43 AM
Anonymous said...: Well, this is right up my Allie so to speak, being sexy and being de.... no, I mean being a dementia nurse.

Yes there was love and romance and trysts behind closed doors on the Alzheimer unit. The only time it was a concern is when one of the patients was comatose, had MRSA, or was dying. Yes, no kidding, I've seen all three scenarios happen for real.; 6/27/12, 9:50 AM
edutcher said...: Hell, The Blonde spent 43 years walking in on people of all ages.

The problem with older people is that they think they have nothing to lose and it doesn't matter how promiscuous they are.

And it's a concern any time because you don't know everything that's being passed around.; 6/27/12, 9:54 AM
Renee said...: If it was my spouse, I would step in and stop. Yes, my spouse would be unable to realize his actions. My spouse though I hope has enough trust in me to place him in a facility, that respected our relationship. He can't be held accountable for his decisions and it is unsafe at home, that is why spouses are placed

Who in the staff is responsible for putting on the condom? If you are in a facility for dementia, you are at the point where one is not capable of self care.; 6/27/12, 10:12 AM
Anonymous said...: Renee, when there are staffing issues in nursing homes (which is a frequent occurance) there are all sorts of scenarios that come up that are not able to be adequately dealt with. Putting a condom on a a horny old gent would simply not happen.; 6/27/12, 10:19 AM
BarryD said...: "The problem with older people is that they think they have nothing to lose"

That's their right as individuals. If you're starting to suffer from Alzheimer's, and you don't figure you will be around for long, it's your goddamned right to screw around if you want to. And usually, you DON'T have anything to lose.; 6/27/12, 10:19 AM
FleetUSA said...: I say let them have their fun while they are still alive (or barely). The line has to be drawn at unwanted advances.; 6/27/12, 10:20 AM
KCFleming said...: So a person no longer competent to consent to a flu shot can consent to sex with, say, a young male worker at the nursing home?

A senile codger grabs at Nurse Betty's breasts, and that's, what, okay?, because he has "the same needs and same desires [he] had before"?

A married woman no longer recalls she's married, but that's okay, she can sleep with Randy Andy who ain't demented and ain't too particular.

Sounds like la la liberal nursing home bullshit to me. Thank God I got outta there.; 6/27/12, 10:29 AM
Anonymous said...: Pogo, you know that sex between staff and patient would never be allowed.; 6/27/12, 10:34 AM
Scott M said...: Pogo, you know that sex between staff and patient would never be allowed.

That's what makes it hot.; 6/27/12, 10:36 AM
Matt Sablan said...: "Pogo, you know that sex between staff and patient would never be allowed."

-- Why? Sexuality is different and the way to establish consent should be different. It's not a high-stakse decision where you really need the capacity to consent to things. It's such a non-thing, why should it not be allowed? If, we actually believe what the article says, as opposed to rolling our eyes at the silliness of it.; 6/27/12, 10:41 AM
Matt Sablan said...: I wonder how that argument will work the next time some guy drugs a woman. "Oh, it wasn't a high stakes decision. She didn't really need the capacity to consent to things."

So. Yeah. How do you even write something like that, and mean it seriously, without realizing how... evil it sounds?; 6/27/12, 10:47 AM
Anonymous said...: Matthew, conflict of interest, favoritism, possible abuse of consent due to cognitive impairment. Sex between staff and demented patients?! I'm a liberal, but some things are simply too much.; 6/27/12, 10:48 AM
KCFleming said...: "Pogo, you know that sex between staff and patient would never be allowed."

I don't know that at all. In fact, the article strongly argues otherwise.; 6/27/12, 10:49 AM
Matt Sablan said...: "Matthew, conflict of interest, favoritism, possible abuse of consent due to cognitive impairment. Sex between staff and demented patients?"

-- How can it be abuse of consent if it is not a high stakes decision where the person doesn't need the capacity to give consent? Yeah, sure, I guess that we can suddenly consider it a super important thing in this, specific instance. But, if in the next, we're pretending it is completely unimportant and trivial, I get confused.; 6/27/12, 10:50 AM
Scott M said...: All the posts today, all the comments so far...and not one mention of the Sword Of Obamacare hanging over our heads. Are we unconsciously holding our collective breathes?; 6/27/12, 10:59 AM
Anonymous said...: Pogo and Matthew, where in the article does it point to sex between staff and patient? It's referring to sex between patients. When one partner has authority over the other and is paid to care for them, sex between them is not comparable to sex between peers.; 6/27/12, 11:05 AM
Jeff with one 'f' said...: Dementia's been complicating my romances my entire life!; 6/27/12, 11:09 AM
Matt Sablan said...: Allie: That's the point I'm trying to make. Someone who cannot knowingly consent is, by definition, powerless. So, the entire set up "Well, s/he can't give consent, but its OK," is wrong. I'm just trying to hit you with enough examples that you see that. The entire underpinning argument is morally bankrupt: They are claiming that if you can't give consent, it is OK. It is not OK. It is, in fact, commonly known as -rape-.; 6/27/12, 11:11 AM
KCFleming said...: "It's referring to sex between patients."

Okay, how about sex between the 80 year old married demented lady and some 50 year old man visiting the nursing home because he knows they can give this lesser consent, the kind that isn't high stakes.

I mean, it's not like he's taking money or anything important like that. He's just a little on the side, and sexuality is 'different'.

"We're saying that sexuality is different and the way to establish consent should be different."
Shit, they stole that line from NAMBLA.; 6/27/12, 11:11 AM
Anonymous said...: Matthew, when a dementia patient is admitted to a unit, they usually have a healthcare power of attorney, the decision to allow that patient to interact sexually with another patient would be a decision made between the patients and their families and / or POA.

I knew what you were getting at.; 6/27/12, 11:15 AM
Bender said...: All the posts today, all the comments so far...and not one mention of the Sword Of Obamacare hanging over our heads. Are we unconsciously holding our collective breathes?

Scott, as the article here asserts, whether or not we consent to getting fucked is irrelevant. Pelosi, Reid, and Obama didn't care if we agreed and consented, and the Court could care even less if we agree with and consent to any of their decisions, no matter how screwed we are as a result.; 6/27/12, 11:19 AM
Matt Sablan said...: Allie: And this article is saying they should not need that: "Many residents who have been diagnosed with dementia rely on family members with power of attorney to make important decisions. Tarzia says that decisions about intimacy shouldn't rise to that level."

The whole argument of the article is, essentially, it is not that important. Which is why we went to patient/care takers. Well, if it isn't that important, what's stopping it? You understand in that context that it is wrong to take advantage of people. The goal was to express that Tarzia's suggestion that there needs to be no real capability to consent was grossly wrong too.; 6/27/12, 11:19 AM
Anonymous said...: Pogo, no staff would allow visitors that were not allowed to interact with the patient access to that patient.If the younger visitor is known to the patient and the family/POA and they agree, then what is the problem?

If the staff felt that the family made a poor decision for the patient, no doubt social services would become involved and more intervention would be warranted.; 6/27/12, 11:19 AM
KCFleming said...: If its not a high-stakes decision then there is no such thing as "date rape".; 6/27/12, 11:21 AM
Anonymous said...: This comment has been removed by the author.; 6/27/12, 11:22 AM
Steven said...: "You get couples who have been living together for 50 years and then they move into a residential care facility. Suddenly they have to have separate beds, and that can be quite distressing for them."

The issue of new relationships is trickier, but at least this should be avoided. I'm not saying it's okay to rape your wife, but if she consented to be your wife when she had full capacity to do so, and she acts willing now, consent should be presumed.; 6/27/12, 11:23 AM
Anonymous said...: Well, who said I agreed with the article in it's entirety? I do think that staff needs to view these patients as sexually viable humans, but continue to provide protection in situations that are clearly abusive.; 6/27/12, 11:24 AM
KCFleming said...: Allie, the author defined away any need for that protection, because sex is low stakes and so abuse is no longer a consideration.; 6/27/12, 11:30 AM
Anonymous said...: OK, OK. the author is full of shit.; 6/27/12, 11:37 AM
Matt Sablan said...: We all agree! Let's have pancakes.; 6/27/12, 11:39 AM
Scott M said...: We all agree! Let's have pancakes.

The hell you say. Waffles only and I will fight you until the end of the Earth over it.; 6/27/12, 11:51 AM
Matt Sablan said...: True enough. Waffles have built in syrup containers.; 6/27/12, 12:00 PM
Anonymous said...: Where's the sausage, the bacon?; 6/27/12, 12:05 PM
Joe said...: I suppose I need to add "I consent to sex with other patients, the nurses, doctors and anyone other female who will fuck me" in my living will.

Hell, I need that now.; 6/27/12, 12:05 PM
Anonymous said...: Leslyn, it all boils down to whether it's a high stake decision or not. I guess it is a high stake decision as evidenced by all the scenarios presented in above discussion, doesn't mean that it can't be made though, with MUCH care.; 6/27/12, 12:09 PM
damikesc said...: Yes there was love and romance and trysts behind closed doors on the Alzheimer unit. The only time it was a concern is when one of the patients was comatose, had MRSA, or was dying. Yes, no kidding, I've seen all three scenarios happen for real.

MRSA? My mom has taught nursing for decades and has spouted off all kinds of odd diseases and afflictions --- that's a new one. What the heck is MRSA?

Not sarcastic --- genuinely curious.

Renee, when there are staffing issues in nursing homes (which is a frequent occurance) there are all sorts of scenarios that come up that are not able to be adequately dealt with. Putting a condom on a a horny old gent would simply not happen.

Is sexual assault an issue? I assume with the issues involved with dementia, it would be a big one...but the only nursing home I ever saw my late grandmother's and she was in the infirmary, which is the single most depressing and horrifying place I ever visited in my life.

I can't imagime working in a nursing home. The realization that all of your patients will be dead, likely in a few years, is just depressing as all heck.; 6/27/12, 12:10 PM
Anonymous said...: MRSA

Very common in long term care facilities and hospitals.; 6/27/12, 12:16 PM
Renee said...: I always had positive feelings in a nursing home. Everyone dies, get over it.

Homes have social activities, there is no need to facilitate sexual behavior. I understand on a dementia unit, it can happen. But it should always be redirected,.

Differences in care from assisted living able body residents with mental capacity.... to a lock down unit for dementia.; 6/27/12, 12:21 PM
damikesc said...: Sounds horrid. I get why mom stuck with pediatrics and adolescent psychiatric.; 6/27/12, 12:25 PM
Matt Sablan said...: "Tarzia is from Australia, so let the Australias deal with her remarks."

-- No. I'm going to pretty much stand that no one, in any country, should condone rape. It's this crazy idea I have that raping people is wrong and should be condemned. Even if you are Australian.; 6/27/12, 12:27 PM
Anonymous said...: Ah, all those pesky shades of gray again.; 6/27/12, 12:30 PM
TMink said...: My uncle, 85, broke his femur and is currently getting better at a rehab hospital/nursing home. His across the hall neighbor is so sexually interested in him that she pulls her pants down at least 4 times a week.

This has been a wonderful motivator for him as she freaks him out and he is working very hard to get back home.

Trey; 6/27/12, 12:55 PM
wyo sis said...: Saltpeter in the kool-aid?; 6/27/12, 1:00 PM
Matt Sablan said...: No. Tarzia said that we needed a way to establish consent that didn't involve having the capacity to consent. In short, letting people do things to you when you can't say no.

Drugged people can't say no either.; 6/27/12, 1:16 PM
BarryD said...: "It's this crazy idea I have that raping people is wrong and should be condemned. Even if you are Australian."

"Yeah? What are ya?"
-an Australian; 6/27/12, 2:43 PM
Crunchy Frog said...: I suppose I need to add "I consent to sex with other patients, the nurses, doctors and anyone other female who will fuck me" in my living will.

Uh Joe, you might want to tighten the grammar up there a little bit. Otherwise, you might be implying consent to be used by Frank, the 350 pound orderly.

I saw him giving you the eye.; 6/27/12, 3:13 PM
Dante said...: Isn't a big problem with STDs and the elderly? How about creating an STD free assisted living place. That way you don't have to worry about the elderly getting AIDs.

Oh wait, that's probably considered unconstitutional.; 6/27/12, 6:14 PM
William said...: At a certain age, doesn't all this just fade away. Maybe, just like in high school, everybody in the nursing home will be partying like crazy and leaving me out of it. But, if so, they're welcome to have at it and leave me alone....I had a friend who worked in a nursing home. She said that when she bent over the bed, some of the drooling codgers would try to look down her blouse. Doesn't it ever end?; 6/27/12, 7:00 PM
Blue@9 said...: At a certain age, doesn't all this just fade away. Maybe, just like in high school, everybody in the nursing home will be partying like crazy and leaving me out of it. But, if so, they're welcome to have at it and leave me alone

I remember reading that nursing homes have pretty high incidences of STDs.

It's probably the best time to have sex. No pregnancies, no worries about marriage or settling down. You're in a place with a bunch of people your age with nothing to do. It's like college but even better. You can get diseases, but I probably wouldn't give a crap if I were 80.; 6/27/12, 7:17 PM
William said...: It's kind of depressing to contemplate nursing home sex. Are there cliques in the dayroom--the stuck up chicks who have hair and teeth and refuse to hang out with guys on walkers. What about those cheap tramps who put flower decals all over their catheter bags? They're just begging for it. It's tricky enough negotiating casual sex when you're young. Your chances of making a complete fool of yourself grow exponentially with age and disability. It's just too depressing to contemplate.....St. Augustine prayed to be saved from the sins of the flesh, but not just yet. I would say that one's nursing home years are an excellent--perhaps ideal is the better word--time to be saved from sins of the flesh. I intend to act with a great deal of decorum and restraint after my stroke.; 6/27/12, 9:25 PM