Sexuality Among Adolescents With Intellectual Disability: Balancing Autonomy and Protection.

Autor:	Enujioke SC; Divisions of Adolescent Medicine sharon.c.enujioke.mil@mail.mil., Leland B; Pediatric Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.; Charles Warren Fairbanks Center for Medical Ethics, Indianapolis, Indiana., Munson E; Indiana Disability Rights, Indianapolis, Indiana., Ott MA; Divisions of Adolescent Medicine.; Department of Philosophy, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2021 Nov; Vol. 148 (5). Date of Electronic Publication: 2021 Oct 28.
DOI:	10.1542/peds.2021-050220
Abstrakt:	Adolescents and young adults living with intellectual disability (ID) have made significant advancements integrating into multiple aspects of western society, but there has been less progress with regards to sexual health. While advocating for individuals with ID to live life to the fullest, pediatricians have practical concerns regarding the ability to consent to sex as well as avoid coercion and manipulation in sexual encounters. This has led to tension between supporting the autonomy of a patient with ID while protecting them from harm. We present a case of a young adult with moderate ID who is engaging in a sexual relationship with her boyfriend without parental knowledge. The pediatrician must decide the most appropriate course of action to support the patient's autonomy but also ensure that the patient is a willing participant and understands the risks of engaging in sexual activity. This case highlights 4 main themes: (1) practical concerns when approaching sexual health in the adolescent with ID, (2) advocating for the rights of those with ID to live life to the fullest, (3) the critical inclusion of individuals with ID in decisions directly affecting them and their peer group, and (4) decision-making capacity and respect for autonomy in individuals with ID. This case highlights the delicate balance providers face when providing care to adolescents and young adults with ID: supporting autonomy to make decisions while reducing harm to a vulnerable population. Competing Interests: POTENTIAL CONFLICT OF INTEREST: Dr Ott’s spouse is an employee of Eli Lilly, Inc. The other authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2021 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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