THE SEXUAL NEEDS OF PEOPLE WITH DISABILITIES – CONTRACEPTIVE NEEDS (UNDER AGE PATIENT)
Legally it is usual to work with the parent or carer if the patient is under age. As they are normally the people requesting help, this is not a problem. It is unlikely that a person under 16 would be seen without such involvement, for the Department of Health Guidelines on working with the under-16s could not be fulfilled if the patient is unable to understand the implications of the consultation. Where there is understanding the wishes and best interests of the patient are paramount.
The use of contraception to help with other problems such as the control of heavy periods, premenstrual tension and hormonally related epileptiform fitting can be considered. The most emotive of all contraceptive methods is sterilization, its importance lying in its permanent nature. Personal choice for the patient is thus even more important. Major issues are raised when a person is unable to exercise their choice because their disability renders them incapable of giving informed consent. Doctors need to consider their own feelings and not allow them to interfere with the decision making. It is not uncommon for the doctor to be pressurized by interested parties for or against the decision to sterilize. Where informed choice is not possible, the ethical and legal implications will need a judicial opinion if the patient is legally an adult, as no-one else is in a position to give consent on her behalf.
*207/197/1*
