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Legal opinion
Learning disability and contraceptive decision-making
  1. Sam Rowlands
  1. Honorary Associate Professor, Institute of Clinical Education, Warwick Medical School, University of Warwick, Coventry, UK
  1. Correspondence to Dr Sam Rowlands, Institute of Clinical Education, Warwick Medical School, Gibbet Hill Campus, University of Warwick, Coventry CV4 7AL, UK; sam.rowlands{at}warwick.ac.uk

https://doi.org/10.1136/jfprhc-2011-005100

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    Introduction

    There have recently been major changes in the law relating to adults who lack capacity to give consent and most textbooks are now out of date on this subject. Many readers will have undergone local training on the implementation of the Mental Capacity Act (MCA) 2005, but this may well have been rather general. [The MCA 2005 can be accessed at http://www.legislation.gov.uk.] This is therefore the time for an up-to-date assessment of the law in this area. This article is not a complete evaluation of the MCA. It does not cover aspects of fluctuating capacity, lasting power of attorney or advance decisions. Its purpose is to raise awareness on this subject for those working in everyday practice in community sexual and reproductive health care, focusing on women with learning disability.

    Learning disability

    Learning disability is the significantly reduced ability of a person to understand new or complex information and to learn new skills, with a reduced ability to cope independently and a lasting effect on development.1 The condition starts before adulthood and is permanent. In terms of function, adults with learning disability will score lower than two standard deviations below the mean on a validated test of general cognitive functioning.2 Learning disability has a spectrum from mild and moderate through to severe and profound. It does not include less disabling problems encompassed by the term ‘learning difficulties’ such as dyslexia.

    Human rights

    Women with learning disability have the same human rights as those with normal intellectual ability. The following extracts from the internationally agreed International Planned Parenthood Federation Declaration on sexual rights (2008)3 are particularly relevant:

    • ■ All persons have the right to be free from violence, including all forms of physical, verbal, psychological or economic abuse, sexual harassment or sexual violence, rape and any other forms of coerced sex …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Commissioned; externally peer reviewed.