[nabs-l] condoms and Sexual Health

Beth thebluesisloose at gmail.com
Sat Sep 8 22:15:48 UTC 2012


I can't believe this, Arielle.  I'll have to tell you ometime 
over the phone.  Do you want my number?  I'll be happy to talk to 
you off lit.  Email me for my number.
Beth

 ----- Original Message -----
From: Arielle Silverman <arielle71 at gmail.com
To: National Association of Blind Students mailing list 
<nabs-l at nfbnet.org
Date sent: Sat, 8 Sep 2012 15:47:02 -0600
Subject: Re: [nabs-l] condoms and Sexual Health

Beth,
Regarding privacy and decisionmaking: I am pasting some 
information to
the bottom of this email regarding the conditions under which 
your
parents are legally allowed to take charge of your medical and 
other
life decisions. I do not know your mental health history well 
enough
to judge whether or not your parents' involvement is still 
justified,
but if you feel they are overstepping their bounds, you may want 
to
consult with the psychologist who wrote this blurb (who happens 
to be
based in Florida). His contact info is at the bottom of this 
message.
Best,
Arielle

A: Competency, in civil legal terminology, refers to the capacity 
to
make independent decisions and conduct legal and financial
transactions on one's own behalf. Adults are generally presumed
competent to handle their own affairs, but this presumption may 
be set
aside by law if there is compelling evidence to the contrary. 
Both the
state and private parties, usually family members, may raise the
issue.

If the court declares a person to be incompetent, that person is
usually appointed a guardian, who is legally empowered to make
decisions regarding another individual's person and property. 
Again,
this is often a family member, but in some cases the court itself
becomes the guardian, and then the person is declared a ward of 
the
court.

The role of the psychological expert in a determination of
incompetency is to conduct an evaluation of the individual's 
mental
function via a thorough clinical examination, review of records,
interview of family members or other collaterals, and the
administration of a number of psychological and 
neuropsychological
tests.

Mental function skills relevant to competency include attention,
concentration, reality orientation, memory, reasoning, judgment,
emotional state, and especially knowledge and appreciation of the
nature and purposes of the decisions that are the subject of the
competency action (e.g. manage finances) and the ability to carry 
them
out (mathematical ability or knowledge of banking rules, 
investing,
etc.).

The law's presumptions of competency of its adult citizens means 
that
the burden of proof is generally on the party challenging the
subject's competency, and what defines "competency" often differs 
from
case to case. For example, the type or degree of mental 
impairment
that would render an individual incompetent to make a will or 
manage
finances, might not be sufficient to deprive them of their right 
to
marry or consent to medical treatment.

Another complication is the nature of the clinical syndrome that
produces the incompetency, which falls into three major classes. 
First
are relatively stable conditions such as severe mental 
retardation or
autism which present lifelong disability, and for which the need 
for
permanent guardianship is evident. Second are slowly progressive
syndromes, such as schizophrenia or Alzheimer's disease, where 
the
point at which impairment worsens to a level warranting 
incompetency
may hardly be clear-cut.

Third are abrupt-onset impairments in mental functioning in a
previously healthy individual, such as from a stroke, traumatic 
brain
injury, or bipolar manic episode. In addition to the issue of
impairment level, these are syndromes that may actually show
improvement over time, so a person incompetent at one point may 
well
meet formal criteria for competency a year later.

The problem is that, in most jurisdictions, guardianships are 
plenary,
that is, they don't distinguish between different types of
competencies (medical, marital, financial), and they don't 
include
time limits. A person that has recovered from a brain injury, for
example, may now have the burden of proof of demonstrating 
restoration
of competency and setting aside the guardianship. Guardians may 
not
always be willing to relinquish their control.

For their part, guardians should consider that they are obliged 
to be
responsible and legally liable for the actions of their ward. To
reduce such risks, some guardians may restrict and control their 
wards
even more than necessary. When difficulties in this area arise,
parties should seek both legal and psychological counseling.

Laurence Miller, PhD is a clinical, forensic, and consulting
psychologist in Boca Raton, Florida. This information is for
educational purposes only, and is not intended to make a clinical
diagnosis or render a legal opinion. Dr. Miller can be reached at
561-392-8881, or at docmilphd at aol.com.


On 9/8/12, Beth <thebluesisloose at gmail.com> wrote:
 Unfortunately for me, my privacy as an adult patient i violated
 on a daily bais if I'm in Florida with my parents.  They want
 protection, protection, protection, but there' nothing wrong 
with
 telling them to go away at thi point.  I am not going to tell 
you
 guy whether or not I wa exually active, but I have a quetsion.
 Mot of u are on Medicaid, right?  I wonder if any of you can 
tell
 me whether a government ervice uch a Medicaid will cover birth
 control pills.  I've been told to try birth control, but I
 already take mental health meds, o I wonder if I should put even
 more bad chemical in my body, and the other thing i that
 government insurance may not cover birth control because it' the
 government.  I don't know because of thoe comment made by the
 demagogue Limbaugh (ome p0o9litical people might know whuat I"m
 talking about.)  And if we elect the wrong peron, I might not be
 able to get free birth control.  Thank.
 Beth

  ----- Original Message -----
 From: Arielle Silverman <arielle71 at gmail.com
 To: nabs-l at nfbnet.org
 Date sent: Sat, 8 Sep 2012 11:00:57 -0600
 Subject: [nabs-l] condoms and Sexual Health

 Hi all,
 I know the recent discussions about sex and dating are kind of 
in
 a
 gray area as to whether or not they're on-topic for this list,
 since
 most of the issues Koby brought up are not really unique to
 blindness.
 So if the moderators or Dave feel this is getting too far 
afield,
 I
 will happily respect your judgment. However, I also think that
 Brandon's question about where to get condoms is a legitimate 
one
 and
 that there might be other blind people out here, including
 teenagers,
 who have similar concerns about how to get condoms, birth 
control
 or
 sexual health information without a lot of awkwardness or
 embarrassment. It can be particularly difficult if you have to
 depend
 on someone else (especially parents) for transportation which 
can
 make
 going to a clinic or drugstore difficult.
 There are a few places to buy condoms online, including
 www.condomania.com
 www.undercovercondoms.com
 and
 www.condomdepot.com
 Believe it or not, they also have some condom choices at
 www.amazon.com
 If you go to your health center on campus for any reason, it
 shouldn't
 be a problem  to ask a doctor or nurse there about condoms.
 I cannot answer the questions about when to begin having sex 
with
 a
 partner because that is a highly individual decision. However, I
 feel
 it important that anyone who is considering having sex for the
 first
 time ensure you understand what all of your options are for
 preventing
 pregnancy and sexually transmitted diseases, the advantages and
 disadvantages of each option, and the proper way to use condoms
 and
 birth control. There are  a couple different websites with this
 kind
 of information:
 www.plannedparenthood.org
 (includes live chat with a sexual health educator) or
 www.scarleteen.com
 This issue is particularly close to my heart at the moment
 because my
 boyfriend's sister just had an unintended pregnancy at a very
 inopportune time (while still in college, with a guy she had 
only
 known for a few months) and was apparently taking birth control
 pills,
 but had not been taking them consistently. While I don't believe
 that
 sex  should be feared, it is something that takes some
 responsibility,
 planning and foresight to ensure it is enjoyable while 
minimizing
 the
 risks. Also, while I won't go into details here, there are other
 ways
 to be physically intimate with someone that are less risky, 
which
 these online forums will talk about.
 I also want to bring up  an issue that is somewhat relevant to
 sexual
 health, which I experienced and I think that some of you might
 also be
 struggling with. This is the issue of having your parents drive
 you to
 doctors' appointments and then having them want to sit in or 
even
 participate in your appointments. Since I attended college in my
 home
 city, my mother always wanted to drive me to my doctors'
 appointments
 and would then want to come in and chat with the doctor while
 he/she
 was examining me. This was partly because my parents and I saw
 many of
 the same doctors and she often thought it was a good opportunity
 to
 ask the doctor a quick question about her own health while she
 was
 there, or because she was curious to see what the doctor
 recommended
 to me about a particular issue. I eventually realized that while
 it
 wasn't ill-intentioned, it was a violation of my privacy as an
 adult
 patient and I asked her to wait in the waiting room while I was
 seeing
 the doctor. I didn't actually take this stand until I was 21 and
 in
 hindsight I wish I had done  it much earlier. By the time you 
are
 18,
 unless you have a serious cognitive disability, you have a right
 to
 privacy of your medical information and it is important to
 establish a
 good doctor-patient relationship without a third person
 interfering.
 This is especially true when it comes to sexual health and by 
the
 time
 you are 18 or even 16, you will want to start discussing your
 sexual
 activities or questions with your doctors without your parents
 being
 around. You might also want to consider getting a driver or even
 taking the bus to medical appointments to avoid this problem.
 On a related note, by the time you are in high school, you 
should
 know
 the names of all medications you take on  a regular basis and 
any
 chronic medical conditions you may have. If you ever have to go
 to the
 emergency room, this kind  of information may be requested of
 you.
 Best,
 Arielle

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