Dementia, Sexuality and the Law

What is it about?

The law is clear on the requirement for contemporaneous consent to sexual activity, thereby creating unmet needs for people with dementia who no longer have the capacity to consent to intimacy/sexuality. This article proposes an instrument known as the Advance Decision on Intimacy (ADI), in pursuit of the concept of precedent autonomy, to empower individuals to make decisions about how they would wish to express their sexuality at a material time in future when they would have lost capacity to consent to such acts.

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Why is it important?

A basic aspect of survival is to love and to be loved and this attribute spans the human existence from cradle to grave, regardless of disability. Some individuals develop dementia and the invariable consequence of dementia is a decline in cognition and level of functioning. Despite the effects of this illness, people with dementia still seek intimacy and companionship as part of their expression of basic human instincts and have the right to equal enjoyment of relationships and privacy for such. At the same time, they have the right to be safeguarded against abuse. In the article, we propose the “Advance Decision on Intimacy (ADI)” - a decision made ahead of schedule by a capacitous individual to accept or refuse acts of intimacy (sexual acts) at a time in future when they will be otherwise unable to make such decisions. Stringent pre-defined processes will be observed before activating the ADI to ensure that otherwise vulnerable individuals are protected whilst engaging in basic experiences of life.

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