Consent, capacity, and client sexuality policies in healthcare

Abstract

Healthcare organizations face significant ethical complexity when developing policies related to the sexual activities of clients within their facilities. On one hand, admission to healthcare facilities should not require clients to abstain from all sexual activity. On the other hand, clients’ sexual activities within facilities have implications for other people, and many clients may be at risk of sexual mistreatment. In response, organizations may be tempted to approach their clients’ decisions about sexual activity on the model of decisions about medical treatment. In this article, we argue that this approach is more ethically problematic than it may first appear. We review asymmetries between the decisional contexts of medical treatment and sexual activity and argue that those asymmetries generate ethical issues for any policy that treats clients’ decisions about sex as analogous to decisions about treatment. We also offer suggestions for the development of ethically justifiable policies related to client sexuality.