Establishing criteria for sexual consent capacity.

Assessment of sexual consent capacity of individuals with mental retardation is a complex problem. A struggle exists between promoting rights and protection from harm when these impairments interfere with the ability to make informed decisions. We examined the consensus of psychologists on specific criteria for sexual consent capacity. Randomly selected doctoral level members (N = 305) of the American Psychological Association completed a questionnaire regarding their opinions about various components of human sexuality. A factor analysis of individual items revealed five factors: Consequences of Sexual Activity, Essential Sexual Knowledge, Unessential Sexual Knowledge, Safety for Self and Others, and Basic Safety Skills. Generally, the factor structure identified basic sexual knowledge, knowledge of the consequences of sexual behavior, and abilities related to self-protection as integral to sexual consent capacity.

Determining the capability of individuals with mental retardation to give informed consent.

Interviews were conducted for individuals without mental retardation and with mild or moderate mental retardation in order to determine their capability to provide informed consent to hypothetical treatment vignettes. Protocols were developed to permit structured interviews, and standardized scoring procedures were devised to provide reliable determinations. Use of these procedures resulted in highly reliable ratings across different clinicians, and the likelihood of being determined capable to provide consent was positively related to level of intellectual functioning. Results point to the need to educate individuals with mental retardation about treatment situations and to balance protection from harm with self-determination.