AIBU to wonder how she is even pregnant???

(58 Posts)
TheSecondComing Thu 10-Jan-13 17:00:52

Message withdrawn at poster's request.

I won't clink because it's the Daily Fail but a decision would have to be made about her capacity to consent. Lots of people with LD have sexual relationships and certainly have capacity to consent.

Theicingontop Thu 10-Jan-13 17:05:13

She has a significant learning disability, she's not incapable of sexual thoughts and feelings. Jesus.

ouryve Thu 10-Jan-13 17:06:20

I'm sure she got pregnant the same as anyone else.

TheSecondComing Thu 10-Jan-13 17:07:38

Message withdrawn at poster's request.

She is pregant. The pregnancy is high risk for her because of her sickle cell. The issue is does she have the mental capacity to understand the risk to herself and make a decision whether or not to continue her pregnancy. A psychiatrist gave evidence that she does have that capacity.

If she is competant to make a decision about accepting the risk of continuing with the pregnancy then, in my view, the court was right to respect her autonomy and not to order an abortion.

What anyone should do is put the title in Google and click on other links, probably from the Telegraph or Guardian, to get a better explanantion of what is happening.

You have assumed that the woman didn't understand the implications of a sexualrelationship.

It is stated in other reports that the woman doesn't want a termination, but the doctors wanted to force one.

"Severe LD's" can mean different things, so it is right that the court decides this and not a medical team.

What do you want? The institutions opening again, so "they" are away, behind walls?

TheSecondComing Thu 10-Jan-13 17:12:18

Message withdrawn at poster's request.

HyvaPaiva Thu 10-Jan-13 17:12:20

Now you're asking 'how is this woman's pregnancy anyone's business?' You didn't ask that in the OP. You said 'how is she even pregnant'. Maybe responses would have been different if you'd asked your new question.

If she has a severe enough learning disability to not be able to consent for herself whether she can have an abortion how can she be deemed able to consent to sex

Two very different issues, from an ethical POV.

She has been found to not lack "Capacity".

mrsmalcolmreynolds Thu 10-Jan-13 17:13:48

Not sure where the OP got the idea that she doesn't necessarily understand conception (couldn't spot this in the article which I forced myself to read) and there appears to be absolutely no suggestion of rape.

Wholeheartedly echo what MrsTerryPratchett and theicingontop said. People with learning disabilities of any level do not need to be infantilised on top of everything else.

CheCazzo Thu 10-Jan-13 17:14:03

What do you want? The institutions opening again, so "they" are away, behind walls?

Where does the OP say or imply any such thing? Jesus - is this another subject that cannot even be raised on MN without incurring the wrath of a certain section of the membership?

www.telegraph.co.uk › News › UK News › Law and Order

www.independent.co.uk › News › UK › Home News

It is in the news as it is of interest, how "Capacity" is judged and the judgements from the High Court on ethical issues.

TheSecondComing Thu 10-Jan-13 17:17:29

Message withdrawn at poster's request.

Theicingontop Thu 10-Jan-13 17:17:35

There would presumably be no court case if she wasn't sickle cell. I don't know why you're questioning how she got pregnant in the first place. There's absolutely no mention of her not being able to engage in, or understand the implications of sex.

Where does the OP say or imply any such thing

The OP asked "how she was even pregnant", or "who impregnated someone who doesn't understand conception".

Having a "learning imparement" doesn'tmean that you cannot live a full life.

I wonder how some of the JK guests could ever be pregnant, but not women who have LD's, tbh.

I am of the "certain section" who has two DD's with LD's (one who has a good career), so the opening tone, was offensive, like it or not.

Capacity is 'task specific' - it is entirely possible for a person to have consensual sex, but lack the capacity to understand the risks to their health wrt to a pregnancy continuing. Or what caring for a baby/child involves.

Phew, difficult. Just because she has the capacity to consent to sex doesn't mean that she understands what the implications of having a very sick baby are though.

Surely it's a scale?

mrsmalcolmreynolds Thu 10-Jan-13 17:22:03

Isn't the point though that she does (in the Court's view) have the necessary capacity to consent (or not) to an abortion, and therefore cannot be forced to have one without her consent? She is mentioned as not having the capacity to represent herself in the legal proceedings, but that is a very different thing.

TheSecondComing Thu 10-Jan-13 17:23:34

Message withdrawn at poster's request.

The Court has held that she has the Capacity to consent to or refuse an abortion. The Doctors are concerned about the risk to her of continuing the pregnancy and want her to have an abortion but the Court has refused to order one saying she has the right to choose.

I am trying to work out why a sexual relationship is the business of the courts

It isn't,the medical team treating her want her to have a termination, looking at this from a "Medical" POV, as opposed to "Social".

They have their job to do, their ethical committee, may have wanted this passed to the High Court, which takes these decisions weekly, you just don't hear about it.

When people are deemed as "Vulnerable" then decisions around sex, contraception and termination has to be handled by those looking after them.

To b eon the safe side, when there is not cleat policy, it goes to committes, which can then pass it higher.

Unless you work in Social Care you probably are less aware of this.

There are cases where the court rules that contraception can be forced, this has just not been looked at sooner.

Contraception has a faliure rate though, so then it moves on to the next stage, termination.

Then if all continues, Child Protection decides who will care for the Baby.

TheSecondComing Thu 10-Jan-13 17:29:22

Message withdrawn at poster's request.

hackmum Thu 10-Jan-13 17:38:14

Laurie: "Just because she has the capacity to consent to sex doesn't mean that she understands what the implications of having a very sick baby are though."

It's not about having a very sick baby. The doctors are concerned that her own life is at risk if she carries the pregnancy to term. The question therefore is whether she can fully understand this or whether they have to make a decision to abort on her behalf. Obviously none of us have ever met this woman so have no idea what her mental capacity is and whether or not she is capable of understanding the risk to her own life.

bottleofbeer Thu 10-Jan-13 17:38:39

If a person has a similar mental capacity as a child I admit I wonder if they should be protected from sex in the same way we protect children from it. Afterall isn't the main reason we do so because they are emotionally too young to deal with it? (and obviously it's sick etc..)

anniroc Thu 10-Jan-13 17:53:43

Gosh I was a bit shocked by this thread. It shows how people are still shockingly ignorant about disability ( not their fault, disabled people are sidelined by society).

I used to work with young learning-disabled people and they certainly had sex, most of the girls were put on the pill or injection by their parents, anxious that this type of situation didn't arise.

You can have emotional intelligence, but severe LD's.

Mental Capacity, or laking of it, doesn't mean that you have the capacity of a child and what the law and others are doing is trying to remove that analogy.

This comes under the problem of "when Care becomes Control".

The reason why we "protect" children from sex, isn't just because of understanding, that is why children are "allowed" under the law to sexually experiment.

Leve lof vunerability will be taken into account when doing a life plan with anyone disabled, who relies on others for support.

It was a long fought battle by people who were/are disabled not to be treated as children.

People with LD's are probably the biggest group (next to the old) who are wrongly "infantilised".

bottleofbeer Thu 10-Jan-13 18:07:06

Thanks for the explanation Birds. I know a man and I've known him for years, as teenagers it was explained to us he had around the same capacity as a six year old. Ignorant of me but I always assumed that was it, he was basically six in all but body.

He's a regular now in a pub I sometimes drink in, always very smartly turned out smile It just seems confusing and I appreciate I've only really given it cursory thought. The 'mental age of six' was probably just a very simple explanation for us at the time.

God love him, he's convinced we're going to get married grin

Vagaceratops Thu 10-Jan-13 18:07:50

My first hope when I read this article this morning was that her vulnerability had not been preyed on.

bottleofbeer Thu 10-Jan-13 18:14:22

That was my thought too Vagceratops, now I understand a bit more through posts on this thread and how individual plans are put in place but I'm a bit hazy on it in some ways too. When an adult is very severely mentally impaired does it still stand that they are adults and able to consent or would it form part of their vunerability assessments? IE: so and so is incapable of making informed choices regarding sex therefore any sexual activity would be wrong?

AmberLeaf Thu 10-Jan-13 19:09:31

She has a significant learning disability, she's not incapable of sexual thoughts and feelings. Jesus

Really? do you honestly think having a learning disability means you are dead from the waist down?

That is simply not true!

Pigsmummy Thu 10-Jan-13 19:14:28

There is a college, run like a village in the area that I am from, specifically for people with learning disabilities and mentally disabled, there is a birth control tablet included with every prescription because pregnancy was rife, sexual desire is a very basic human function, contraception isn't

McNewPants2013 Thu 10-Jan-13 19:21:32

I don't belive an abortion should ever be forced.

If it is down to medical concerns about the mother, what about other groups. Poor example but if a mother to be has cancer and is refusing treatment to save her unborn child should she be forced to abort because her life is in danger.

LettyAshton Thu 10-Jan-13 19:26:51

I met a woman who was fostering a baby who was the child of two severely learning disabled people. Although it was that rarest of things, the "newborn, white, healthy" baby, not one person on the adoption register wanted it.

Presumably there are other babies like this, who will end up in the care system. Perhaps we should consider them.

BearsLikeMarmalade Thu 10-Jan-13 19:56:13

Bottleofbeer - yes, you've hit the nail on the head, 'mental age of 6' would have been an incredibly over-simplistic and deeply unhelpful explanation. People with LD develop different abilities at different rates, and whilst thinking developmentally can be a useful way of understanding a particular issue for a person (e.g. level of receptive vocabulary), applying age brackets to people on a global basis is pretty much always unhelpful, and not supported by any standardised assessments. Yes, you always assume capacity. That is very clear in the legislation. No-one has to prove that they have capacity in order to be 'allowed' to do something. Assessments of capacity are only triggered if there are legitimate concerns that someone might lack capacity to make a specific decision.

Birdsgottafly's comment about emotional intelligence is spot on (loving your work on this thread by the way). I work with people with LD and very often see greater degrees of emotional intelligence in my client group compared to those without LD.

I think the reporting of the woman as in the "bottom 1%" in terms of intelligence doesn't necessarily help. Most people with LD would score around this level on cognitive tests because they are not hugely sensitive at this level of ability. In actual fact there is a massive range of abilities in different areas of understanding - hugely variable and person specific, ranging from mild levels of LD to severe/profound. Although this woman is reported as being 'severely impaired' in some of the media reports, I think it likely she has mild-moderate LD (technically IQ 50-70 not that IQ is hugely meaningful). I regularly assess people's intellectual ability and their capacity to make various decisions and there does not seem to be a clear correlation between scores on a cognitive test and whether someone has capacity to make a certain decision or not. This is why the Mental Capacity Act is such an important piece of legislation, it ended the assumption of incapacity based on presence of LD. The independent article has some good quotes from the judge on this.

bottleofbeer Thu 10-Jan-13 20:09:26

Thanks for the explanations, you learn something new every day. Although if I'd ever really given it proper thought it's quite obvious that one size doesn't, never has and never will fit all.

I'm going to hold my hand up to my level of ignorance on this; in my mind whenever I see him it's always in the back of my mind that quote "mental age of six" and because I didn't think too deeply about it beyond that I did wonder if it was ok for him to be drinking in a pub - to me it was like letting a six year old go drinking but obviously making allowances for the fact he's now actually 40. Horribly ignorant of me, I realise this now.

It's really so bleeding obvious to me now that LD can mean so many things, and yes, a person might be seriously delayed intellectually but not so emotionally. Socially he's obviously got LD but really, he's got loads of mates and he's well...fine. Bloody funny too!

I see it all rather differently now. Thanks smile

BearsLikeMarmalade Thu 10-Jan-13 20:18:16

bottleofbeer, it would be great if more people could reflect on these issues the way you have smile

bottleofbeer if only all people listened and thought as you do. It is true that the 'mental age' thing gets bandied around. I worked with a young man, 20s who had parents who insisted on telling people he had the mental age of I think 8. He got into a lot of issues with younger women because they were told this. Of course he had the hormones of a young man. Not a good mix.

It is very important to make capacity assessments and decisions based on individual things. You could find that someone has a lot of knowledge and insight in one area and not another. IQ is a terrible measure and so is looking at prior capacity assessments.

mightycheeks Thu 10-Jan-13 21:58:37

Just to highlight that having sickle cell disease does not, in itself, necessarily mean that a woman is unable to have a perfectly healthy pregnancy. This lady has severe sickle cell disease as shown by the fact she has had numerous strokes. Normally after a stroke patients are put on long term transfusion programmes to prevent further strokes by reducing the percentage of sickle cells in the blood. I would be interested to know when she had her strokes. I have known people who have had several strokes as children who have made excellent recoveries. It all sounds a bit odd to me.

bottleofbeer Thu 10-Jan-13 22:01:31

Ah yeah of course, I suppose even if they are seriously delayed in every way their bodies aren't. God that must be such a difficult situation.

mightycheeks Thu 10-Jan-13 22:29:05

You would not know that the majority of people with sickle cell disease even had sickle disease if you met them when they are well! They do have problems with long term organ damage e.g. kidney failure but it varies a lot person to person. It is an inherited condition, in the same way cystic fibrosis is. The most prominent symptom is pain when they get sickle shaped red blood cells sticking in the little blood vessels supplying their organs and bones. It is agonising. Anyway this is not what the thread is about - but sickle cell is something I know about so thought would share smile.

Yes bottle and worse. What if a young woman with LDs wants to date 'normal' boys (her words, not mine)? She doesn't want to go out with a boy from the day centre but a boy down the road. Well, a lot of the boys with no LDs who want to date a girl who has LDs want to because she is vulnerable to abuse; sexual; financial, you name it. She doesn't want to see it but her family is worried to death. She has capacity to consent. He is taking her money, taking her phone. Now, this could happen to a neuro-typical young woman. I would still be worried but not as worried IYSWIM.

Or the man who is low level bullied by his friends at work. They call him Spaz and similar. But, he likes work and them and he gets to go down the pub after work and to the footie with them. They call each other stupid, offensive names as well. Is it abuse, is it OK? Do you challenge or not?

This is why people should be nice to SWs, because when you work in this field these are the things you are awake at 3am thinking about.

Theicingontop Thu 10-Jan-13 23:28:04

Amberleaf, re-read what I said.

Not just sw, my sister is a LD nurse and it keeps her awake at night,

I know a few bloody amazing LD nurses so she is in good company.

I see this case as an example of where the system has worked. Doctors had, I assume, a legitimate medical concern about the health of a patient. Because of the patient's LD they were not clear whether or not she had capacity to understand the possible risk of her pregnancy. The matter was put before the court to determine whether or not she had capacity to decide to continue her pregnancy. The court found that she did.

The doctors were in a difficult position because they can't just act, especially as this isn't an emergency situation, but they can't ignore the fact that a patient might not understand that they are at risk.

AmberLeaf Fri 11-Jan-13 00:19:34

icingontop I was so outraged that I missed the 'not'

sorry blush

HopAndSkip Fri 11-Jan-13 02:08:15

Hmm, it seems like it must be very severe LD to have gone to court rather than her being left to make her own decision though? I agree with OP that it raise's the question of the circumstances she got pregnant in. (As far as I'm aware normally doctor's wont try to legally force an abortion on an adult woman regardless of her health?)

At 18 weeks she's coped a fair way. Hopefully a few more weeks won't make much difference, and they can deliver early without too much harm to mum or baby. Having had a severely premature baby, I don't think abortions should be preformed this far on, never mind forced on a woman.

There is a middle ground between Court and being left to make her own decisions. This is a quite common thing, for people with LDs to have people make capacity decisions. I have made them. This happens between mild and severe LDs. Someone could have a relatively mild LD but with other issues, autism for example, and relationships and sex are difficult to understand. Someone with a more severe LD could understand sex because they had a very open and motivated parent. That is why they have to be made for each case and decision.

BTW Chaz great post.

Jamillalliamilli Fri 11-Jan-13 09:36:36

This is why people should be nice to SWs, because when you work in this field these are the things you are awake at 3am thinking about.

Perhaps we could also consider being nice to families looking after people with LD’s too? We’ll be awake at 3am (actually it’s 1.30 and 4am here) for the rest of our lives, dealing with the repercussions of decisions made by SW’s now worrying about another client, moved on, or long left the field.

I’d like to remind people discussing this, that not only is there a young woman and an unborn child’s fate being decided here, but also the future of her mum, and sisters who will have little choice in coping and potentially into the next generation too, with whatever the end results of this pregnancy bring them all.

Decisions can be a life sentence for families, there is no indication of their views, they're just the carer's, the people who will be left dealing with it all, after the interested parties have moved on.

Families who care deeply are often left with all the responsibilities of other people’s decisions but none of the rights.

PandaOnAPushBike Fri 11-Jan-13 11:22:53

Gosh I was a bit shocked by this thread. It shows how people are still shockingly ignorant about disability ( not their fault, disabled people are sidelined by society).

I used to work with young learning-disabled people and they certainly had sex, most of the girls were put on the pill or injection by their parents, anxious that this type of situation didn't arise.

I'm not, I've come across it before on this forum. I have a daughter who is high functioning autistic. She is extremely intelligent and capable in some areas but emotionally very immature, lacks impulse control and often doesn't connect consequences with actions (although on an intellectual level she does). She got into a relationship when she was 16 (is still with him now 4 years on) so I sought advice on here about how best to proceed with contraception for her. I got ripped apart because I should be preventing someone emotionally younger than 16 from being in a relationship let alone having sex, not enabling it.

A poster earlier summed it up: capacity to consent is task specific. My daughter was fully able to decide who she wanted to be with and what she wanted to do with them. She is also fully able to understand the implication of pregnancy (thankfully). She lacked the capacity to sort out the right type of contraception.

bottleofbeer Fri 11-Jan-13 12:14:41

I'm seriously considering going into SW myself and have been for a while.

Perhaps we could also consider being nice to families looking after people with LD’s too? We’ll be awake at 3am (actually it’s 1.30 and 4am here) for the rest of our lives, dealing with the repercussions of decisions made by SW’s now worrying about another client, moved on, or long left the field.

I agree. I know it can seem like SWs float in and out. For the record, I left the job. I had to (emigrated). I still think of the clients I had and the carers who made their lives better, my life better and saved the country untold money. They are some of the best people I will ever meet. If there was any way of thanking two in particular, the sister of one client and the mother of another, I would.

JuliaSqueezer Fri 11-Jan-13 15:32:44

Someone I know has learning difficulties as does her boyfriend. Her family were a bit concerned she was putting weight on and took her to the GP fully expecting him to help with a diet plan. Nope, she was pregnant, and too far gone for any other option but to have the baby.
Their son was born without any learning difficulties and they are a very happy family unit, living in their own home and getting by with help from extended family and some social care.
She hadn't been 'taken advantage of', just very much in love with her partner who had a similar IQ to hers smile

Some v good and insightful posts on here.

Julia, I know of several cases like the one you described and clearly these families have their ups and downs like any other family; some of course with more input and support than others.

I also know of cases were when a pregnancy was only found late on, the baby was adopted. Or, were the decision was made that it was in the best interest of the woman to terminate the pregnancy.

I think that just shows that people with LD face the same dilemmas and difficult life decisions as the rest of us. The added challenge is assessing how much of the decision making can be left to them, their carers, when HCP need to be involved and when SW/legal avenues.

The most upsetting case of a termination I've had dealings with not that long ago was a NT schoolgirl whose father had decided she was 'getting rid of it'. She never had any say in the matter, much as I and the counselling nurses at the Woman's Unit tried. It was not so much that anybody thought she ought to NOT have a termination, but that the decision had to be hers. And guess what, we are now dealing with the MH fall-out from that event sadangry. And that had nothing to do with LD...

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