Ukubhekisele kuDilemma Ethiable of Consent Informed for Intimacy in Dementia
Uma kuziwa ekudemeni komqondo , kunezinkinga eziningana zokuziphatha ezingase zithuthuke njengomphumela wokushintsha ukuqonda. Omunye walabo umbuzo ongenza amalunga omndeni omdala angakhululekile ngoba ekhuluma ngomsebenzi wesondo nobudlelwane obuseduze, kodwa yisihloko esidingekayo ngaso sonke isikhathi ukubhekana nazo. Umbuzo yilokhu: Ingabe abantu abane-dementia bangaqhubeka bevuma umsebenzi wezocansi?
Futhi, uma kunjalo, bayakwazi nini ukwenza kanjalo?
Inselele Yokunquma Isivumelwano
Kungenzeka yini ukuthi umuntu onokuphefumula komqondo angaqonda isinqumo asenzayo nemiphumela engaba khona? Ngokusobala, impendulo akuyona ebo elula noma cha.
Umgomo wokubuza, nokuzama ukuphendula, umbuzo wokukwazi ukuvuma uhlangothi olubili:
1. Ukuvimbela ukuxhashazwa ngokocansi komuntu osengozini okungenzeka akakwazi ukulwa noma ukubika
Ngenxa yenkinga yememori kanye nezinkinga zokuxhumana ezingathuthuka ekudemeni kwengqondo, kubalulekile ukuqapha ukuhlukunyezwa okungenzeka komuntu ohileleke ekusebenzeni ngokobulili ngokumelene nentando yakhe.
Abantu abadala, ikakhulukazi labo abanenkinga yokucabanga, i-target elula yokuhlukunyezwa kwazo zonke izinhlobo , kufaka phakathi ucansi.
Ngokomthetho, umuntu kufanele abe namandla okucabanga ukuze avume isenzo socansi. Umbuzo wendlela yokunquma ukuthi ngabe lowo mandla ukhona yini onzima ukuphendula.
Ingabe kukhona isigaba esithile sokuwohloka komqondo lapho lokhu kungekho emthethweni nokuziphatha okubi?
2. Vikela amalungelo omuntu osengozini ukuba ahlanganyele emsebenzini wokuhlanganyela ocansini owenziwe ngokobulili owenzelwe futhi okhuthaza izinga lokuphila
Ukunakekelwa kwe-dementia sekude kakhulu ekutholeni ukuthi ngenxa yokuthi isifo so-Alzheimer (noma uhlobo oluthile lwesifo sengqondo somqondo ) lukhona, isifiso sokusondelana asikhiphi ngokuzenzakalelayo.
Futhi akekho umuntu ngokuzenzekelayo noma ngokushesha olahlekelwa amandla okuvuma umsebenzi wezocansi uma ehlungwa.
Esikhundleni salokho, ucwaningo luye lwabona izinzuzo eziningi zokuthinta abantu abane-dementia , futhi ochwepheshe be-dementia bagcizelela ukubaluleka kokunakekelwa komuntu obhekene nokucindezeleka komqondo . Amanye amakhaya asebekhulile kanye nezindawo zokuhlala ezisize abhale izinqubomgomo ekuqapheliseni izidingo ezingokomzimba, ezingokomzwelo, ezingokwengqondo, ezingokomoya nezokucansi zalabo abazinakekelayo.
Yiziphi Izinto Okufanele Kucatshangelwe Ngombuzo Wokuvuma?
Uma abantu ababili-oyedwa noma bobabili abane-dementia-abonisa isithakazelo ekuphishekeleni ubuhlobo bobulili nomunye nomunye, yimiphi imibuzo okufanele ibuzwe? Ngenkathi kungekho uhlu olunzulu oluvunyelwene yizazi, nansi ezinye izici ezingasiza kule sinqumo:
- Ukuqashelwa: Ingabe umuntu ngamunye uyaqaphela njalo? Ingabe bayayazi igama noma indawo yokulala yomunye nomunye? Ingabe umuntu oyedwa ucabange ngephutha ukuthi lo mlingani nguye oshade naye uma engekho?
- Intshisekelo: Ingabe bobabili bafuna ukuhlala ndawonye njalo? Ingabe kukhona nesithakazelo ebuhlotsheni obulula nobungane, noma inentshisekelo kwezobudlelwane bobulili?
- Ukukhulumisana kwemizwelo ngezwi nokukhuluma: Ngabe ukuxhumana kwabo ngamazwi nangamazwi akusho ngani? Uma ebuzwa, ingabe umuntu ngamunye uveza isifiso sokuchitha isikhathi nomunye? Uma uzibona zihlangana, zombili zithandana futhi zibonakala zijabule? Bangakwazi yini ukuphendula imibuzo mayelana nobuhlobo babo futhi bakhombise isifiso sokuthandana ngokomzimba?
- Amandla okuthi "Cha": Ingabe umuntu ubonisa noma yiziphi izimpawu zokucindezeleka, njengokukhipha ukucindezeleka ngokomzwelo, ukwesaba, ukuphumula, ukunciphisa isifiso sokudla, noma ukuvuselelwa ngokomzimba kokuthinta? Ingabe bobabili abantu abakwazi ukusho ukuthi "Cha" (ngamazwi noma kungabi ngamazwi) kokuxhumana kocansi okungadingeki? Ngabe umuntu ngamunye angabonisa ukuthi "ukude kangakanani" abafisa ukuqhubeka nokuxhumana kocansi? Isibonelo, ungumuntu oyedwa okuqukethwe ngokumanga nokuthinta, kanti omunye uzama ukuqhubekela phambili emisebenzini engaphezulu?
- Ukulimala: Ngabe izinga labo abathintekayo bayakwazi ukuxhashazwa? Ingabe umuntu ngamunye unalo ikhono lokubika okungafuneki ngokomzimba komunye umuntu? Ingabe lowo muntu ngokuvamile usekelwa ngokusekelwa ngumndeni noma ingabe yedwa?
- Umphumela emkhakheni wokuphila: Ingabe ubuhlobo bubonakala buzokwenza ngcono izinga lempilo yabantu bobabili? Ingabe ubuhlobo obuqinisiwe bokuzinikela kokubili noma ubungane obusha?
Izinto eziyinkimbinkimbi
Ngezansi kunezici ezengeziwe okufanele zicatshangelwe:
Ukungakwazi Ukubamba iqhaza Ezinqumweni Zezokwelapha
Kuthiwani uma omunye noma bobabili abantu sebezimisele ukungahlanganyeli ezinqumweni zezokwelapha, ngaleyo ndlela kusebenze amandla ommeli ? Ingabe lokhu kubenza ukuthi bangakwazi ukuvuma imisebenzi yocansi?
Ngokuzizwa kahle, umuntu angase angakwazi ukuqonda ngokuphelele ukubunzima kwesinqumo sezokwelapha kodwa okwamanje ngokucacile nangokuqhubekayo akwazi ukukhombisa ukuthi bafisa ukuba nobuhlobo nomunye nomunye. Ngokomthetho, amandla okuvuma acatshangwa ngaphandle kokuthi kuboniswe ngenye indlela.
Umndeni, u-Guardian, noMandla wezeMpilo we-Attorney
Kuthiwani uma amalungu omndeni, umgcini oqokwe enkantolo noma amandla okunakekelwa kwezempilo ommeli aphikisana nobudlelwano?
Kuvamile ukuba amalungu omndeni abe nokukhathazeka okuphawulekayo nokuqondakalayo ngokuphepha komzimba womuntu othandekayo, ikhono lokuxhashazwa, ukuhlazeka umzali wakhe onesithakazelo ebuhlotsheni bobulili, ukukhathazeka okusekelwe ekukholweni ngokuziphatha komzali, nesifiso ukuvikela isithunzi sothandekayo wabo.
Abanye abalobi bezinqubomgomo kanye nabacwaningi bakhuthaza ukuvikelwa okuphelele kwelungelo lobudlelwane ekudemeni komqondo futhi ngaleyo ndlela bazizwe kungukuthi ukuhamba kwemfihlo ukukwazisa imindeni.
Abanye bacindezela ukuthi uma umuntu ehlala esikhungweni sokunakekelwa, lesi sikhungo sinesibopho sokuvikela abantu abangabandakanyeka ebuhlotsheni. Ngakho-ke, amaqembu afanelekayo kufanele aziswe ngeso simo ukuze alondoloze ukukhulumisana okuvulekile mayelana nentuthuko yayo, ikakhulukazi uma ubuhlobo obusha. Lokhu kukhulumisana kungacatshangwa ukuthi kokubili kudingekile futhi kuvikelwe ngokumelene nesenzo somthetho uma iqembu elibhekelekile lingavumelananga.
Indlu YesiHeberu eNqubomgomo ye-Riverdale (isikhungo esiye saholela endleleni yokuxoxa ngalolu daba) sikisela ukufundisa amalungu omndeni ngezidingo zomhlali futhi aqinisekise ukuthi ohlala khona ukuze alondoloze izinga lokuphila, okungenzeka ngokusebenzisa ubuhlobo bobulili, ngaphezu kwamanye izinyathelo.
Ngezikhungo, ingozi kule nkinga ukuthi amalungu omndeni abathintekayo angase afake icala noma isikhalazo kumnyango esifundazweni oqondisa ukulandelwa emakhaya asebekhulile uma bengavumelani nendlela isikhungo esisingatha ngayo ubuhlobo. Esikhundleni sokubheka ubuhlobo njengokhetho oluthuthukisa ikhwalithi yokuphila, bangase babe nomuzwa wokuthi lesi sikhungo siphumelele ukuvikela umhlalaphansi osengozini futhi kufanele kube nomkhawulo wokuxhumana noma ukuvimbela ubuhlobo ukuba buvele.
Ubuhlobo obusha nobudlelwane obusungulwe
Ingabe ubuhlobo obusungulwe ukuthi bobabili abantu bangena ngokuzithandela ngaphambi kokuqala komqondo wokuhlaselwa komqondo futhi manje bahlala, noma ubuhlobo obusha? Ngokuvamile, ukusungulwa kobudlelwane ngaphambi kokuba kube khona ukushada komqondo kwenza isinqumo sibe lula kakhulu-hhayi ngoba ukuhlukunyezwa akunakwenzeka ngaphakathi komshado (noma ubuhlobo obusungulwe) -kodwa ngoba isinqumo sokuba nobuhlobo bobulili senziwa ngenkathi ikhono lomuntu lokuqonda ingangabazi.
Uma kutholakala ubudlelwane obusha ngemuva kokudemuka kwengqondo, umbuzo othi, "Bangeke bakwenze lokhu uma bengenayo i-dementia?" kuvame ukucelwa. Noma, "Wayengeke afune ubuhlobo obuseduze ngaphambi kokulahlekelwa inkumbulo yakhe." Uzobe ehlazeka kakhulu. "
Uma ubuhlobo obusha, ingabe izinqumo zomuntu kanye nezintandokazi ezedlule kufanele zicatshangelwe? Ngenkathi ezinye izazi ziphakamisa ukuthi izintandokazi nezinkolelo zangaphambilini zomuntu kufanele zithinte izinqumo zanamuhla, abanye bakhuthaza ukuba bahlolisise lowo muntu ngaphandle kokukhomba ukuthi izinqumo zabo, izintandokazi kanye nezidingo zabo zamanje zini, nokuthi yini ebangela ukuba kube khona impilo enamanje.
Ukuchazwa kokuLawulwa kweMithetho kaHulumeni noma ku-Federal Surveyors
Enye yezinkinga ekuphenduleni lobudlelwano uma kwenzeka endaweni ekhulisayo yilabo abacwaningi (labo abaphethe ukuqapha ukulandelwa kwemithethonqubo yezempilo) bazohumusha isimo.
Ngenxa yobuningi bokuzicubungula inqubo yocwaningo, abahloli abahlukene ababili bangafinyelela iziphetho ezimbili ezihlukene kakhulu ngesimo esifanayo, ukucabanga ngalunye ukuthi wenza into efanele ekuvikeleni izakhamuzi nasekuhlonipheni amalungelo abo okukhetha.
Omunye ucwaningo angaphetha ngokuthi lesi sikhungo sakwahluleka ukuvikela ohlala kulo ekuxhaphazweni ngokocansi ngenxa yokuntuleka kobufakazi bokuthi umuntu ohlala khona angavuma, ngaleyo ndlela ephetha lowo ohlalayo wayehlukunyezwa ngokocansi. Omunye umcwaningi angaphetha ngokuthi lesi sikhungo sakwahluleka ukuvikela ilungelo lomhlali ukuba akhethe futhi ajabulele izinga lempilo ngokugcina ubuhlobo obuseduze, obuseduze uma ubuhlobo bubekwe ngaphandle kodwa abuvunyelwe. Izakhiwo zivame ukufakwa emdlalweni wokuqagela ukuthi abahloli bangase bahumushe kanjani isimo.
Abanye basikisela ukuthi ilungelo lokuhlanganyela ubudlelwano bocansi kufanele lugcinwe ngaphandle uma ubufakazi bukhombisile ukuthi akuyona inzalo. Abanye balondoloza ukuthi labo abathintekayo kudingeka baqinisekise ukuthi bavuma ngokuqondile ubuhlobo, njengoba kunikezwe ukuthi umthetho udinga imvume.
Icala lezomthetho elibandakanya imvume yokusebenza ngokocansi kanye ne-dementia
Ngo-2015, umbhangqwana wenza izindaba ngenxa yalowo mbuzo wesikhundla sokuvuma imisebenzi yocansi. Lo mbhangqwana-uHenry noDonna Rayhons-bahlala e-Iowa futhi bashada ngo-2007 ngemva kokuhlangana kamuva ekuphileni. Eminyakeni eminingana kamuva, uDonna wathola isifo se-Alzheimer.
Ngokushesha ngoMeyi 2014, lapho uHenry Rayhons, oneminyaka engu-78 ubudala, esolwa ngokuhlukumeza ngokocansi umkakhe ekhaya labahlengikazi lapho ehlala khona ngenxa yokugula kwakhe komqondo.
AmaRayon aphikisana ngokuthi akazange alale nomkakhe ngalobo busuku kodwa wathi babekade bange futhi bethintana. Uphinde wabika ukuthi uqale ukuxhumana ngocansi ngezikhathi ezithile. Indlu yokuhlengikaza lapho umkakhe ehlala khona, kodwa, wayenomuzwa wokuthi akavumanga ukwenza umsebenzi wocansi futhi wabika le nkinga emaphoyiseni ngemuva kokuzwa ukuthi izenzo zocansi zenzeke phakathi kwalaba ababili.
Ekugcineni, leli cala laya enkantolo futhi, ngemva kokufakaza nokuziphendulela, ijaji lafumana amaRayson engenacala. Kodwa-ke, leli cala laphakamisa imibuzo eminingi mayelana nokusebenza kocansi phakathi kwabantu abaphila nokuphefumula komqondo, kuhlanganise nendaba yokunquma amandla okuvuma nokuthi ngubani okufanele enze leso sinqumo.
Ingabe Kufanele Kusetshenziswe Iziqondiso Zokuxoshwa Ngezocansi?
E- Alabama Law Review , u-Alexander A. Boni-Saenz uxoxa ngomqondo wokuvumela abantu ukuba bahlele idokhumenti eveza ukukhetha kwabo ngokocansi uma kwenzeka bengenakukhubazeka ngokwengqondo. Isibonelo, omunye umuntu angasho ukuthi afuna ukuqhubeka nokuhlanganyela emsebenzini wobulili nomlingani wakhe lapho engakwazi ukukhubazeka kwengqondo. Umcabango ophakathi kwalabo abeseka lo mbono uhilela ukulondoloza ilungelo lokuhlanganyela emisebenzini yokucansi ezuzisayo, ngokuvamile phakathi kobudlelwane obuzibophezelekile, nokuvimbela ukuthi kungenzeka ukuthi ushushise ubugebengu ngenxa yokukhubazeka kwengqondo.
Labo abaphikisana nalo mbono bakhomba ukuthi nakuba umuntu engase afune ukulondolozwa kwesokudla ngenkathi amandla akhe engqondo eqinile, angase asabele ngokuhlukile uma ukuqonda kwakhe kunqabile. Isifo se-Alzheimer kanye nezinye i-dementias zingashintsha ubuntu bese zandisa ukukhathazeka noma ukukhathazeka. Ngokomthetho, lo mbuzo ungase ukhonjiswe njengezintandokazi kanye nokukhetha kokuzibonela okwamanje kanye nokwabantu esizayo. Ukubikezela ukuthi kuzoba yini okuzuzisa futhi okufisiwe ukuze kugcinwe ikhwalithi yokuphila esikhathini esizayo kuba nzima lapho izifo ezibangelwa ukuguga komqondo zingashintsha izintandokazi, ikhono lomzimba kanye nesithakazelo.
Izwi elivela
Le ngxabano igcizelela isidingo samakhaya asebekhulile kanye nezinye izindawo zokunakekelwa ukubhala izinqubomgomo eziphenywe kahle, ezichazwe futhi ezihlala phansi ngokuphathelene nobuhlobo phakathi kwabantu lapho eyodwa, noma kokubili, ine-dementia. Lezi zinqubomgomo zingaqondisa izikhungo ezinqumweni zabo futhi zihlinzeke ngokuqondisisa kwababheki ukuze baqonde isisekelo sezinqumo njengoba bebukeza lezi zimo.
Kumele futhi ukhumbule ukuthi ukuphatha le nkinga yokuziphatha kudingekile ngaphezu kwemigomo. Ukuba nomnyango ovulekile wokukhulumisana namalungu omndeni kubalulekile ekubhekaneni nezidingo ezishintshayo zomhlali kanye nemibuzo enzima eyakhayo, njengokuvuma ubuhlobo obuseduze.
Okokugcina, izakhiwo zidinga ukwazi izakhamuzi zabo-kuhlanganise nokusebenza kwabo kokuzicabangela nokuthi yimiphi imisebenzi ekhulisa kakhulu izinga labo lokuphila-ukuze kuthi uma lezi zimo ziphakama, isinqumo ngasinye sigxile kumuntu ngabanye futhi ngokucacile sisekelwe ekuthandeni kwakhe okuhle.
Lesi sihloko akufanele sichazwe ngokungahambisani nezeluleko zomthetho. Bheka ummeli obhekene nalolu daba ngezeluleko zomthetho.
> Imithombo:
> Iforamu ye-Bioethics. Ubulili, Ukuvuma kanye ne-Dementia. Ngo-Ephreli 15, 2015. http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=7378&blogid=140
> Ikhaya LamaHeberu e-Riverdale. Ngo-Ephreli 2013. Izinqubomgomo nezinqubo eziphathelene nokukhuluma ngokocansi ekhaya laseHeberu e-Riverdale.
> Hegde S, u-Ellajosyula R. Izinkinga zokukwazi nokuthatha izinqumo ekudemeni kwengqondo. Amanothi we-Indian Academy of Neurology . 2016; 19 (I-Suppl 1): S34-S39. doi: 10.4103 / 0972-2327.192890.
> I-New York Times. Ngo-Ephreli 22, 2015. I-Iowa Man Found Ayinacala Ekuhlukunyezwa Ngomuntu Ngomkakhe Ngama-Alzheimer's. http://www.nytimes.com/2015/04/23/health/iowa-man-found-not-guilty-of-sexually-abusing-ife-with-alzheimers.html?_r=0
> I-Society for Post-Acute and Long-Term Care Medicine. Ngo-Mashi 19, 2016. Amandla Okuvuma Ngokwezocansi Ekudemeni Ekunakekeleni Kwesikhathi Eside. https://paltc.org/amda-white-papers-and-resolution-position-statements/capacity-sexual-consent-dementia-long-term-care
> I-International Longevity Centre. 2011. I-Taboo Yokugcina: Umhlahlandlela wokuwohloka komqondo, ubulili, ukusondelana nokuziphatha kocansi emakhaya okunakekelwa. http://www.ilcuk.org.uk/index.php/publications/publication_details/the_last_taboo_a_guide_to_dementia_sexuality_intimacy_and_sexual_behavior
> Isikhungo se-Weinberg nekhaya lesiHeberu ku-Riverdale. 2011. Ukuhlukunyezwa noma ukungathandana. I-Older Adult Sexualtiy.http: //www.riverspringhealth.org/uploads/ckeditor/files/sexualconsentguidelines.pdf