Psychiatrists talk about sex a lot, apprently, so it's about time it was blogged.
The Mental Capacity Act 2005 has had explanation on it's implementation through the Code of Practice which presents helpful guidance.
I have a lady who has dementia. She enjoyed frequent intimate relations with a longstanding friend who has had a turn for the worse and been admitted to hospital. When his name is mentioned her face lights up.
Since he was admitted months ago, another man has started seeing my patient who is an affable old dear and opens her door to anyone. He has started having intimate relations with her. She has repeatedly told nursing staff she doesn't like him but then on other occasions is confused and is more ambivalent. When his name is mentioned she recoils. Her daughter is mortified the man who her mum hardly knows has no relationship with mum except for sex and wants the man to go away and never see mum again.
Within the meaning of the Mental Capacity Act 2005 she is an incapacitated adult. She can not consent to sex. The Code of Practice says in 1.10 that there are ". . . specific decisions which can never be made . . . by family members, carers, professionals, attorneys or the Court of Protection." The subsequent list includes, "consenting to have sexual relations."
She can not consent to having sexual relations and the Mental Capacity Act 2005 makes it clear that nobody can consent on her behalf.
Is it that incapacitated adults can't have sex? Can the issue be ignored? Is it that a man, having sex with a woman without consent, should be charged as a sex offender?