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The so called project on working on is my nephew. He has…

The so called project on...

The so called project on working on is my nephew. He has Down syndrome. He is 18 years old, and having sexual relations with another student who's also 18. He says it's consensual, but my sister has her doubts. She thinks the girl is taking advantage of him. We already contacted a lawyer. My nephew supposed to have some determination of his cognitive status. I'm guessing his mental age. What else gets assessed to determine his capability to give consent.

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Answered in 6 days by:
3/9/2018
LeahMSWuofm
LeahMSWuofm, Clinical Social Worker
Category: Mental Health
Satisfied Customers: 960
Experience: 10 years post-MSW experience
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Hi, thank you for writing. The basic assessment for capacity would involve his ability to understand the risks and implications of his behaviors. So if your nephew is able to understand implications about pregnancy, infections, etc. and also have the cognitive capacity to mitigate against these risks appropriately, that would likely be one huge component of assessing his capacity. So if he knows sex leads to pregnancy but can't iterate ways to prevent tis, that would not work in his favor. Another domain will look at his ability to assert why he is making the choice. Can he rationally explain why he is having these sexual relations with this person and are these reasons his own or does it seem like his explanations are apparent to be the direct influence of another. So if he says, "I like this because if feels good and makes me happy" versus" I like it because she tells me that I should keep doing it to make her happy", that would be considered. Lastly, can he communicate these things effectively? So can he reiterate the risks after they are explained using his own words and can he reasonably explain why he is making the choice he is making. So basically, does he understand the choice he is making, does he express a clear preference for the behavior for his own gain, does he understand the risks involved and can he control those risks, and does he have the reasoning to explain why he is engaging in this relationship versus choosing not to.

People like your nephew's primary care doctor or alternative doc ho has worked with him for a long while should know him well enough to exert whether hey think he can reasonably consent. moe thorough cognitive assessment will ultimately be telling too, although subjective assessments in these cases can be as important as the objective.

I hope this helps. I am glad your nephew has you guys looking out for him!

-Leah

LeahMSWuofm
LeahMSWuofm, Clinical Social Worker
Category: Mental Health
Satisfied Customers: 960
Experience: 10 years post-MSW experience
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Customer reply replied 1 month ago
His mental age has been determined as 14 years old. Will that have an impact?
Customer reply replied 1 month ago
What is a mental age test, and would it have an impact on the doctors' findings

Hi, I apologize i am not free for a phone call. The mental age determination may be mildly taken into account (depending on the source of the determination) but isn't likely to be a primary factor. For one, 14 may be too young to consent to sex as an age, but it certainly isn't too young to understand the implications of having a sexual relationship. So again, I don't believe this would be a huge factor overall in a determination to say he was able to consent. The things I mentioned above are going to be much more heavily weighed.

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Customer reply replied 1 month ago
For some reason, I thought mental age was a factor. If he has the mentality of a 14 year old, does that override his chronological age?

It may be considered as one factor but again. not the only thing to consider. Understanding/Determining capacity is not as a black and white as a single domain making that call. If his mental age had come back at 5 years od, I think that would be weighed more carefully but 14 implies ability to understand the implications of his actions and take action towards them, so I worry that it isn't enough to go on.

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LeahMSWuofm
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