Consent and sexual ethics in severe brain injury cases

Sexuality and Severe Brain Injury

Ethical issue

The ethical issue in this case study is the fact that Mr. Z decides to have sexual intercourse with his wife Mrs. Z who is brain damaged. Her current state does not allow her to make any valid and sober decision. The action by Mr. Z is unethical since for one to have sex they should give consent, this is however not possible for Mrs. Z since she is unable to speak. This is a clear indication that she is not able to participate in even basic decision making leave alone giving consent to sexual intercourse. The severe mental disability leaves Mrs. Z incapable of giving any valid consent to intercourse. The act of having sexual intercourse with a an individual without her direct consent is quite unethical since Mr. Z is engaging in intercourse with someone who has not given consent even if she is the wife.

Consequences of possible actions

One of the possible actions in this case would be to retain Mrs. Z at home where her husband and children are. This decision would be reached obviously after taking into consideration the benefits and harms of keeping her home. One possible consequence of keeping her at home is the fact that she will be close to people who love her, her husband and children. Even though her husband engaged in sexual intercourse with her it does not mean that he does not care for his wife. He did not want to harm his wife in any way but tis just shows how much he loved her despite her current state. Therefore staying at home would mean that she would be around her husband who loves her unconditionally and hence is best when it comes to taking care of her. The "goodness" that is associated with the consequences is the fact that she will be taken care of by people who love her and hence this guarantees that she will get the best care at home.

Another possible action is that Mrs. Z could be taken to another setting where she will be taken care of by other caregivers. This means that she will be away from her husband and children and under the care of other caregivers. One possible "goodness" of this consequence is the fact that there will not be a repeat of such an incident since the husband would not have the opportunity of engaging in sexual intercourse with her since she would not be under his care.

Decision making model

I would suggest an ethical decision making model for this case. This model has several steps which are;

Problem identification, identification of potential issues involved, reviewing relevant ethical guidelines, knowledge of relevant laws and regulations, obtaining consultation, consideration of possible and probable cause of action, listing of consequences of the probable course of action and deciding on what appears to be the best course of action (Syracuse University,1998).

Articulate an action of choice

I would choose that Mr. Z be taken to another setting. This is because according to her husband, he is entitled to sexual intercourse with his wife regardless of her state. This means that there is nothing that is going to prevent him from engaging in sexual intercourse with Mrs. Z again. Therefore taking her away from home and placing her to another facility is the only sure way of preventing a repeat of this from happening again.