scholarly journals Sexual rights, mental disorder and intellectual disability: practical implications for policy makers and practitioners

2018 ◽  
Vol 24 (6) ◽  
pp. 386-397 ◽  
Author(s):  
Helen Dewson ◽  
Keith J. B. Rix ◽  
Isabelle Le Gallez ◽  
Kartina A. Choong
Keyword(s):  
Decision Making ◽  
Intellectual Disability ◽  
Mental Disorder ◽  
Sexual Behaviour ◽  
Pregnancy Termination ◽  
Sexual Relationships ◽  
Physical Contact ◽  
Sexual Expression ◽  
List Type ◽  
International Human Rights Law

SUMMARYClear policies regarding sexual expression, sexual behaviour and related decision-making assist in ensuring that the rights of people with mental disorder or intellectual disability are upheld, and that staff know how to react to situations consistently and lawfully without interfering on the basis of their own moral judgements or personal beliefs. Sensitive and holistic planning of care that complies with domestic law, international human rights law and statutory guidance is necessary to complement such policies. Non-intimate physical contact, masturbation, sexual relationships, contraception, sterilisation and vasectomy, pregnancy, termination of pregnancy, sexual dysfunction, parenthood, marriage and civil partnership, divorce, prostitution, pornography, and sex aids and toys are all matters that may properly be part of care planning.LEARNING OBJECTIVES•Understand the limited legal basis for the formulation of policies and rules concerning sexual expression, sexual behaviour and related decision-making by people with mental disorder or intellectual disability•Be able to formulate policies concerning sexual matters as they relate to people with mental disorder or intellectual disability•Be able to plan care for psychiatric patients and community service users balancing their rights to sexual fulfilment with the protection of their own welfare and the protection of othersDECLARATION OF INTERESTNone.

scholarly journals Sexual rights, mental disorder and intellectual disability: principles and law

2018 ◽  
Vol 24 (5) ◽  
pp. 334-345 ◽  
Author(s):  
Isabelle Le Gallez ◽  
Keith J. B. Rix ◽  
Kartina A. Choong ◽  
Helen Dewson
Keyword(s):  
Intellectual Disability ◽  
Mental Disorder ◽  
Well Being ◽  
Case Law ◽  
Sexual Relationships ◽  
Learning Objectives ◽  
Sexual Expression ◽  
List Type ◽  
Sexual Rights ◽  
Staff Attitudes

SUMMARYPeople with mental disorder and intellectual disability have the same rights to sexual expression as other people, albeit that in some cases a lack of capacity may require curtailment of those rights and regard must be had to protecting the vulnerable. Furthermore, the formation or maintenance of sexual relations, or the attainment of sexual fulfilment, may assist in the maintenance or restoration of mental health or well-being. This article demonstrates how the courts in England and Wales, applying statute law and judicial precedent, are largely supportive of the rights of people with mental disorder or intellectual disability to make decisions about sexual expression, sexual relationships and related matters, notwithstanding some societal and staff attitudes that act to prevent them fulfilling their sexual needs and making decisions about sexual and reproductive matters.LEARNING OBJECTIVES•Understand the underlying principles that apply to the exercise of their sexual rights by people with mental disorder or intellectual disability•Understand some of the obstacles to the exercise of sexual rights by people with mental disorder or intellectual disability•Understand the statute and case law that apply to the exercise of sexual rights by people with mental disorder or intellectual disabilityDECLARATION OF INTERESTNone.

scholarly journals Education versus screening: the use of capacity to consent tools in psychiatric genomics

2019 ◽  
Vol 46 (2) ◽  
pp. 137-143
Author(s):  
Camillia Kong ◽  
Mehret Efrem ◽  
Megan Campbell
Keyword(s):  
Decision Making ◽  
Human Rights ◽  
Intellectual Disability ◽  
Informed Consent ◽  
Mental Disorder ◽  
Screening Tools ◽  
Relational Autonomy ◽  
Decision Making Capacity ◽  
Genomics Research ◽  
Ethical Tension

Informed consent procedures for participation in psychiatric genomics research among individuals with mental disorder and intellectual disability can often be unclear, particularly because the underlying ethos guiding consent tools reflects a core ethical tension between safeguarding and inclusion. This tension reflects important debates around the function of consent tools, as well as the contested legitimacy of decision-making capacity thresholds to screen potentially vulnerable participants. Drawing on human rights, person-centred psychiatry and supported decision-making, this paper problematises the use of consent procedures as screening tools in psychiatric genomics studies, particularly as increasing normative emphasis has shifted towards the empowerment and participation of those with mental disorder and intellectual disabilities. We expound on core aspects of supported decision-making, such as relational autonomy and hermeneutic competence, to orient consent procedures towards a more educative, participatory framework that is better aligned with developments in disability studies. The paper concludes with an acknowledgement of the pragmatic and substantive challenges in adopting this framework in psychiatric genomics studies if this participatory ethos towards persons with mental disorder and intellectual disability is to be fully realised.

HEMMUNG VON TESTOSTERONABHÄNGIGEN DIFFERENZIERUNGSVORGÄNGEN DER MÄNNLICHEN RATTE NACH DER GEBURT

1967 ◽  
Vol 54 (2) ◽  
pp. 227-240 ◽  
Author(s):  
F. Neumann ◽  
J. D. Hahn ◽  
M. Kramer
Keyword(s):  
Sexual Behaviour ◽  
Cyproterone Acetate ◽  
Post Partum ◽  
Sexual Attitude ◽  
Normal Male ◽  
Corpora Lutea ◽  
List Type ◽  
Newborn Rats ◽  
Neonatal Treatment ◽  
Triangular Shape

ABSTRACT Male newborn rats were injected with 2 mg of an antiandrogen (1,2α-methylene-6-chloro-pregna-4,6-dien-17α-ol-3,20-dione-17α-acetate = cyproterone acetate) daily from their 1st to their 14th day of life. The following effects of this treatment were observed in these animals after onset of sexual maturity: 84% of the animals are unable to reproduce. Penis: the frenulum is broadened to a lamina of triangular shape, which almost completely prevents the preputium from being pushed back. These males show a rather insufficient male sexual behaviour towards females in oestrus. After castration and ovar implantation, some of the treated animals show true corpora lutea and at attempts of cohabitation partially female sexual behaviour towards normal male animals. From these results it can be concluded, that differentiation of the penis is not completed at the time of birth. The infertility of the animals may be caused by the penile changes (difficulties with intromission) as well as by the aimless sexual behaviour. This aimless sexual behaviour, the ability to produce true corpora lutea and finally their partially female sexual attitude under the influence of the hormones from the implanted ovaries led to the conclusion, that the above described neonatal treatment apparently inhibited testosterone-depending post partum developments of sexual differentiation in hypothalamic centers.

7 Exploring healthcare professionals’ attitudes to future care planning with older adults in hospital: qualitative research co-design through multi-professional patient and carer involvement

2018 ◽  
Vol 8 (3) ◽  
pp. 362.2-362
Author(s):  
Anna-Maria Bielinska ◽  
Stephanie Archer ◽  
Catherine Urch ◽  
Ara Darzi
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
End Of Life Care ◽  
Healthcare Professionals ◽  
List Type ◽  
Care Planning ◽  
Life Care ◽  
Topic Guide ◽  
Future Care ◽  
Advance Care

IntroductionDespite evidence that advance care planning in older hospital inpatients improves the quality of end-of-life care (Detering 2010) future care planning (FCP) with older adults remains to be normalised in hospital culture. It is therefore crucial to understand the attitudes of healthcare professionals to FCP in older patients in the hospital setting. Co-design with patients carers and healthcare professionals can generate more detailed meaningful data through better conversations.AimsTo co-design a semi-structured interview (SSI) topic guide to explore healthcare professionals’ attitudes to FCP with older adults in hospital.MethodsA multi-professional research group including a panel of patient and carer representatives co-designed an in-depth topic guide for a SSI exploring healthcare professionals’ attitudes to FCP with older adults in hospital.ResultsThe co-designed topic guide encourages participants to explore personal and system-level factors that may influence attitudes to FCP and practice in hospital amongst healthcare staff. Co-designed topics for inclusion in the SSI schedule include:Potential differences between specialist and generalist approaches to FCPThe influence of perceived hierarchy and emergency–decision making ability in professionals on FCP discussionsThe relevance to transitions of careAttitudes to FCP beyond the biomedical paradigm including perceived well–being and psychosocial aspects of careDigital FCP tools including patient–led FCP.ConclusionCo-designing qualitative research with older people and multi-disciplinary professionals may narrow translational gaps in implementing FCP by setting joint research priorities. Data generated from a co-designed study may expand understanding of hospital-based anticipatory decision-making with older adults.Reference. Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ23 March 2010;340:c1345.

The Legislative Decision-Making Process

1982 ◽  
Vol 32 ◽  
pp. 7-8
Author(s):  
Richard DeGraw ◽  
Bette F. DeGraw
Keyword(s):  
Decision Making ◽  
American Indians ◽  
Undergraduate Students ◽  
Community Organization ◽  
Role Play ◽  
The Political ◽  
Decision Making Process ◽  
List Type ◽  
Provision Of Services ◽  
Legislative Decision

The Legislative Decision Making Process is an educational role play for graduate or undergraduate students concerning the political and pressure relationships involved in the political decision-making process. The role play reviews the implications of the decision-making processes upon the provision of services by governmental agencies.The role play engages from twenty to sixty students in a simulated budget-making and lobbying experience and utilizes this experience to teach students:1.The values and pressures considered by bureaucracies and the Legislature in decision-making;2.The relationships which exist between clients, community groups, administrators and politicians;3.The various techniques of Community Organization for lobbying and Legislative influence.The role play consists of various groups of students in roles which include legislators, administrators of three major state departments, two minor state departments, parent groups, Concerned Citizen groups, American Indians disabled individuals and ex-clients.

Co-occurring mental disorder and intellectual disability in a large sample of Australian prisoners

2013 ◽  
Vol 47 (10) ◽  
pp. 938-944 ◽  
Author(s):  
Shannon Dias ◽  
Robert S Ware ◽  
Stuart A Kinner ◽  
Nicholas G Lennox
Keyword(s):  
Intellectual Disability ◽  
Mental Disorder ◽  
Large Sample

How Persons with Intellectual Disabilities Are Fighting for Decision-Making Rights

2022 ◽  
Vol 121 (831) ◽  
pp. 30-35
Author(s):  
Chester A. Finn ◽  
Matthew S. Smith ◽  
Michael Ashley Stein
Keyword(s):  
Decision Making ◽  
Intellectual Disability ◽  
United Nations ◽  
Intellectual Disabilities ◽  
Legal Capacity ◽  
Disability Rights ◽  
Persons With Disabilities ◽  
New Approach ◽  
The United Nations

Paternalistic attitudes about what is in the interests of a person with an intellectual disability have long led to abuses, and are embedded in the guardianship laws still in place in most countries. Self-advocates, who identify as people with intellectual or other disabilities and are committed to demanding their rights and educating others about them, are calling for a new approach. They have found support for reforms in the Convention on the Rights of Persons with Disabilities, adopted by the United Nations in 2006 and since acceded to by 182 countries. By supporting the fundamental right of those with disabilities to make decisions, it has enabled disability rights advocates to successfully challenge legal capacity restrictions and push for “supported decision-making.”

scholarly journals A decision-time account of individual variability in context-dependent orientation estimation

2019 ◽  
Author(s):  
Ron Dekel ◽  
Dov Sagi
Keyword(s):  
Decision Making ◽  
Visual Processing ◽  
Initial Conditions ◽  
Decision Time ◽  
Individual Variability ◽  
Perceptual Bias ◽  
Large Individual ◽  
List Type ◽  
Tilt Aftereffect ◽  
Context Dependent

AbstractFollowing exposure to an oriented stimulus, the perceived orientation is slightly shifted, a phenomenon termed the tilt aftereffect (TAE). This estimation bias, as well as other context-dependent biases, is speculated to reflect statistical mechanisms of inference that optimize visual processing. Importantly, although measured biases are extremely robust in the population, the magnitude of individual bias can be extremely variable. For example, measuring different individuals may result in TAE magnitudes that differ by a factor of 5. Such findings appear to challenge the accounts of bias in terms of learned statistics: is inference so different across individuals? Here, we found that a strong correlation exists between reaction time and TAE, with slower individuals having much less TAE. In the tilt illusion, the spatial analogue of the TAE, we found a similar, though weaker, correlation. These findings can be explained by a theory predicting that bias, caused by a change in the initial conditions of evidence accumulation (e.g., prior), decreases with decision time (Dekel & Sagi, 2019b). We contend that the context-dependence of visual processing is more homogeneous in the population than was previously thought, with the measured variability of perceptual bias explained, at least in part, by the flexibility of decision-making. Homogeneity in processing might reflect the similarity of the learned statistics.HighlightsThe tilt aftereffect (TAE) exhibits large individual differences.Reduced TAE magnitudes are found in slower individuals.Reduced TAE in slower decisions can be explained by the reduced influence of prior.Therefore, individual variability can reflect decision making flexibility.

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