Literature Review on Provision of Appropriate and Accessible ...

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The review examined national and international legislation - falling under
civil and criminal law - relevant to women with intellectual disabilities’
experience of sexual relations and pregnancy. Legislation relevant
to specific decisions and tests of capacity was explored, i.e. capacity
to consent to medical treatment and, in particular, to contraceptive
treatment and capacity to consent to sexual relations.
Support to People with an Intellectual Disability who are
Accessible
and Appropriate of Provision on <strong>Review</strong> <strong>Literature</strong>
Experiencing Crisis Pregnancy
There is a history of civil law cases relating to capacity to consent to
medical treatment and much research on decision making capacity
has concerned consent to treatment. Meanwhile, it has been observed
that there has been far less consideration of capacity in the context of
consenting to sexual relationships (Murphy, 2003). For example, there is
no specific test designed to cover capacity to consent to sexual relations
in the context of the civil law concerning a person’s private rights to enter
into voluntary relationships (BMA and the Law Society, 2004). Capacity
to consent to sexual relations arises in the context of the provisions
available in criminal law to protect vulnerable people from potentially
abusive relationships.
6.2 Assessment of capacity to consent to contraceptive treatment
In Ireland, the Scheme of Mental Capacity Bill 2008 sets out the various
provisions relating to assessing capacity of vulnerable people to make
specific decisions, excluding capacity to consent to have sexual relations.
The legislation is relevant to this topic in relation to the assessment
of capacity to make medical treatment decisions, i.e. decisions about
contraception, including sterilisation.
6.3 Gaps in relation to assessment of capacity to make
healthcare decisions
Gaps in the current draft legislation and procedures in relation to
assessment of capacity to make healthcare decisions include the
following:
• Where an adult does not have the capacity to consent to or refuse
medical treatment, it is common medical practice in Ireland
to have their next of kin sign a consent form in relation to the
treatment (LRC, 2005). This practice has no legal standing. This
vacuum in the law could produce a situation where the right of a
woman with intellectual disability to make decisions about her