Is it right to sexually assist a paralysed patient? - page 13

How do you deal with the paralysed patient with frequent erections? Have you ever been asked to assist? I've never faced this but have seen a heated discussion on another forum. Is it humane to bring... Read More

  1. by   bukko
    Quote from Roland
    1. Create a volunteer organization that would provide manual stimulation to qualifying disabled individuals (the specific guidelines would need to be rather specifically, and exhaustively defined, and codified). In the same way that many volunteer to build homes, serve in Haiti, work in homeless shelters, and do other things it is likely that some would be willing to volunteer for this service.
    Hmmm, that would put a new twist on the term "pink ladies." Might make a few faces red as well...
  2. by   Agnus
    Quote from jkaee
    "I'm shocked by the people who have all but condemned me for even asking it. Even more shocked by those who feel it's not a topic for discussion. Herein lies the problem - nurses not even wanting to discuss aspects of the patient's life they don't feel comfortable with. Surely this bury your head in the sand approach cannot be healthy."


    I don't believe anywhere on this thread said that they wouldn't be willing to counsel a patients about his/her sexual frustrations, or refuse to discuss it with them. You specifically asked in your OP if a nurse would help, or "do" it for a patient. BIG difference.


    "Given the situation I think his actions were humane and kind."


    Shooting an injured horse is "humane and kind" as well, doesn't mean we're gonna do it to our patients, though.


    "...................sentence cut for personal attack like nature.................. (it was a quote not from this author."


    I'm sorry, WHO'S being immature? I think that statement alone completely discredits you.



    "As an atheist I could never pray with a patient, I would call for the hospital chaplain. I understand nurses who say they could never respond to requests to sexually relieve an immobile patient and like praying, this should never be an EXPECTED part of the nurses role. Where there is no partner to perform this function, there is perhaps an argument for bringing in the services of a paid sex worker. Nurses who do perform this humane act are not satisfying their own sexual desires, and allusions to porno/sexy **** nurses are unnecessary and unhelpful."



    Well, in the majority of the USA any paid sex worker is illegal, so that's just not an option. Like others have said, no one has died from lack of orgasm or sexual release. Yes, I feel for them. Yes, I would discuss their feelings with them. I'd get SS and possibly their family involved with the pts consent. Anything more than that is not "humane" as you like to call it, it's inappropriate and would likely result in an immediate termination or suspension of one's nursing liscence, if reported. And as for your last comment.....most prostitutes aren't doing it for their own sexual desires, either. That's irrelevant.



    "It strikes me as sad that on a non-nursing forum, this issue was discussed with greater sensitivity and maturity than here. That people could attack me for even raising the issue, or say that they laughed and thought it was a joke, is not conducive to open discussion. Doesn't free speech mean anything to nurses?"



    For crying out loud, PLEASE don't start with that "free speech" whine! People laughed because it was so ridiculous to even consider doing that for a patient, because we know what the repurcussions could be (leaving aside any moral issues). For most, there is no discussion. And with 10 or so pages of replies, I hardly think the topic was ignored. And, if you explore a bit on this website, I assure you that you would find that "freedom of speech" is a right that is alive and well-exercised among us nurses. The fact remains that it isn't something that could ever be up for debate among the majority of nurses, and if that makes us less "sensitive and mature" than your other forum collegues, then so be it.
    You did not read the entire thread as you stated that no where did you see that counseling would be provided by any of us.
    My post seems to be ignored by a lot a folks here and that is OK. I did talk about this issue without displaying an emoational ewww reaction. I spoke professionally. I spoke about counseling on several levels.

    Please, do not judge all people of a profession from a thread like this. One emoational reaction lead to another on a thread like this. Nurses are human and come from many backgrounds. We are not all educated to handle situations like this. Unfortunately sensitivity to this and other hot issues are not well handled even by our nursing professors. So do not condem the nurses here. There were some sensitive answers. Please, go back and sift those out.

    This is NOT and issue we are taught to deal with. Just as most physicians are not taught how to handle sensitive situations. We simply do not have people to observe and model. You like the others can ignore my post and in doing so perhaps are just as blinded by the emoational aspect of this. I believe I did handle my response in a sensitive and professional manor. FACT is at least in the USA this is not within the nurses scope of practice. However I did offer a soultion that was both professional and sensitive, and realisticm, and had a very high probability of being very helpful. Dont' thow the baby out with the water.

    No apology needed. Just take your own advice and sift out and ignore the ignorance. As it stands now it apears to me that you have been caught up in the nonsense your questions stimulated instead of the sensible responsed you did receive.

    You have sunk to the level of those you are condeming you. What a pity.

    edited for typos only
    Last edit by Agnus on Apr 7, '04
  3. by   Roland
    Quote from Agnus
    You did not read the entire thread as you stated that no where did you see that counseling would be provided by any of us.
    My post seems to be ignored by a lot a folks here and that is OK. I did talk about this issue without displaying an emoational ewww reaction. I spoke professionally. I spoke about counseling on several levels.

    Please, do not judge all people of a profession from a thread like this. One emoational reaction lead to another on a thread like this. Nurses are human and come from many backgrounds. We are not all educated to handle situations like this. Unfortunately sensitivity to this and other hot issues are not well handled even by our nursing professors. So do not condem the nurses here. There were some sensitive answers. Please, go back and sift those out.

    This is NOT and issue we are taught to deal with. Just as most physicians are not taught how to handle sensitive situations. We simply do not have people to observe and model. You like the others can ignore my post and in doing so perhaps are just as blinded by the emoational aspect of this. I believe I did handle my response in a sensitive and professional manor. FACT is at least in the USA this is not within the nurses scope of practice. However I did offer a soultion that was both professional and sensitive, and realisticm, and had a very high probability of being very helpful. Dont' thow the baby out with the water.

    No apology needed. Just take your own advice and sift out and ignore the ignorance. As it stands now it apears to me that you have been caught up in the nonsense your questions stimulated instead of the sensible responsed you did receive.

    You have sunk to the level of those you are condeming you. What a pity.

    edited for typos only
    Agnus, it is not clear to me if you are suggesting that the SEX therapist which you advocate being brought in, should provide sexual contact (as some actually DO although they are usually called sexual surrogates to distinguish them from actual therapists). Indeed, Masters&Johnson actually designed an instructional/ protocal for Sexual surrogates (at least I have seen this referenced in the websites of these people). However, for the disabled person who DOES desire sexual gratification, but is not capable of self stimulation it is doubtful that mere discussion would be adequate. Also, someone above asked the question if we would be concerned about disabled WOMEN who lacked visible indications of their desire. Did this person read my New York Times article which detailed how DOCTORS at one time induced orgasms in women (not just disabled women either) as a form of MEDICAL therapy (perhaps a nurse at the time who attempted such an intervention would have been guilty of practicing medicine without a license!)

    Again, I would emphasize that almost no one here is advocating that doctors or nurses perform these functions. I actually, think the proposal for direct, electrical "neurogenic" stimulation to the brain holds the most promise for people in this situation (and the promise of such direct brain interface goes far beyond just the sexual since this technology may make it possible for paralyized people to communicate, and directly control artificial limbs).
  4. by   Palpitations
    If the patient is having reflex erections, I don't think that he's in need of sexual stimulation. If it's not reflex erections, but full "sock it to me mama" erections, then he should be able to have a wet dream. That is what wet dreams or for.

    David did this patient ask you to relieve his frustrations? Are or you assuming that he wants you to help him out?

    Melinda
  5. by   Roland
    David, was VERY clear in saying that he had never experienced this issue personally, and was not likely to do so in his current position. Like me he is interested from an intellectual perspective. Perhaps, my agnostic leanings are coming out in that I see much of sex as nothing more than a series of neurological, and chemical reactions that culminate in a physiological outcome not unlike eating, drinking, or elimination (as my wife sometimes insinuates I make Dr. Spock the Vulcan, seem like the life of the party!).
  6. by   Palpitations
    Quote from Roland
    David, was VERY clear in saying that he had never experienced this issue personally, and was not likely to do so in his current position. Like me he is interested from an intellectual perspective. Perhaps, my agnostic leanings are coming out in that I see much of sex as nothing more than a series of neurological, and chemical reactions that culminate in a physiological outcome not unlike eating, drinking, or elimination (as my wife sometimes insinuates I make Dr. Spock the Vulcan, seem like the life of the party!).

    Like I said: If he's capable of having a full-blown "sock it to me mama" erection, then he should be able to have a full-blown wet dream. Is that a good enough "physiological outcome" for you? Dr. Roland?

    Melinda
  7. by   Hellllllo Nurse
    I read in an old nursing book once that "assisting" a pt in this way was "expected" of a nurse in certain situations. This is insane. Nurses are not prostitutes.
  8. by   Spidey's mom
    Just sat here and read this whole thread in one sitting.

    To the original question - the reason people laughed is because it is laughable that anyone would consider this appropriate nursing practice. No one is saying you can't ask the question but be prepared for the answers. Absolutely no is my answer.

    Ask any teenage boy . . . . wet dreams work!!

    I saw no prudishness or unenlightened comments from those who thought this was completely inappropriate behavior from a nurse to a patient.

    I do think comparing what Mother Teresa did and what Roland and David are suggesting is disrespectful.

    I think prayer and satisfying someone's sexual needs are completely and utterly different.

    I do not care what "the Dutch" do.

    Most of the time we are talking about reflex erections which the patient cannot feel. If a person wants to have a fulfilling sex life, there are actually lots of resources for them and their spouses, s.o.'s, etc., and this is addressed by their physicians or counselors.

    steph
  9. by   Marie_LPN, RN
    Quote from Roland
    (as my wife sometimes insinuates I make Dr. Spock the Vulcan, seem like the life of the party!).

    WTMI (way too much information) :stone
  10. by   Roland
    be willing to participate in the "volunteer" organization that I proposed as one possible solution. My point was that people have proven TIME and again that they will endure GREAT personal risk, and discomfort to help people in numerous situations (thus if there are volunteers willing to care for dying patients with Tuberculosis, AIDS ect then they could be found for MY proposal). Furthermore, my statements reflect my actual thoughts as to considering doing the work that Mother Theresa did. Frankly, if I didn't have a family I probably WOULD join her organization or something very much like it.

    I'm not sure the wet dream analogy holds up under sruitiny. As someone who has gone months and even years without sex at various points in my life (self stimulated or otherwise) I have only experienced these sort of "dreams" a COUPLE of times in my early teenage years. Furthermore, if the process was as "self regulating" as you describe then studies such as the one published the other day would not show a benefit to regular sexual activity (since the body would take care of the situation itself). What exactly IS the argument against people with disabilities getting these sort of services IF they request them (again NOT from Dr's or Nurses)? The only argument that I can think of is a moral/religious one which is not deemed sufficent in any other area of public policy debate (ie gay marriage's, civil unions, abortion ect). We have decided as a nation to become a SECULAR society you can't "pick and choose" the issues where you want to be "moral" in such a society. People say they want a "Godless", secular society then I say fine CHOKE on it and all of the ramifications of such a world (one of which is that you no longer get to use morality in public policy debates). Also, as pointed out above it's not just the "Dutch" or are insinuating that the Austrailians are also somehow also "wacky" on this issue?
    Last edit by Roland on Apr 7, '04
  11. by   hobbes
    Just more food for thought for those of you that insist that nobody ever died from not having sex. Maybe....maybe not. My point in posting this is to challenge the knee-jerk attitude that some seem to have that sexual release is something base and that even the thought of assisting a debilitated person is doing so is beyond professionalism. Although I don't necessarily condone the practice in the scope of nursing, primarily due to legal and practical implications, I don't find the thought appalling as some, and can see why the OP posed it. :



    http://www.cnn.com/2004/HEALTH/04/07....ap/index.html

    CHICAGO, Illinois (AP) -- Contrary to some research, frequent sexual activity does not increase the risk of developing prostate cancer and might even reduce the danger, a study of nearly 30,000 men found.

    Some previous studies have suggested that men who have frequent ejaculations -- whether through sex or masturbation -- might be more prone to prostate cancer. One theory is that lots of sex exposes men to various germs and viruses that somehow lead to prostate cancer.

    The latest study should be "reassuring to those men who may be more active than others," said Dr. Durado Brooks, prostate cancer director for the American Cancer Society.

    The study involved 29,342 health professionals ages 46 to 81 who were asked about their ejaculations in their 20s, 40s and during the previous year, 1991. During about eight years of follow-up, 1,449 men developed prostate cancer.

    On average, the men overall had four to seven ejaculations a month. No increased risk of prostate cancer was seen in men who reported more frequent ejaculations, and there appeared to be a decreased risk in men with the highest reported levels.

    The two highest activity levels -- 13 to 20 ejaculations a month, and at least 21 a month -- were linked with decreased cancer risks of 14 percent and 33 percent respectively.

    One theory is that frequent ejaculations help flush out cancer-causing chemicals or reduce the development of calcifications that have been linked with prostate cancer.

    But relatively few men in the study reported heavy sexual activity, so more research is needed to establish whether there is, in fact, a link, said Dr. Michael Leitzmann, a researcher at the National Cancer Institute who led the study.

    "It's too early to suggest that men should change their sexual habits to alter their prostate cancer risk," he said.

    The study appears in Wednesday's Journal of the American Medical Association.

    The theorized connection between frequent sexual activity and prostate cancer is not entirely far-fetched: High levels of the male hormone testosterone can cause a strong sex drive and can also fuel the growth of cancer cells.

    The study involved mostly white men. Leitzmann said it is unclear whether similar results would be found in blacks, who have much higher prostate cancer risks than whites. But he said the biological mechanisms that might explain the results probably do not differ by race.

    Prostate cancer is the second most common cancer in men, after skin cancer. One in every six men will develop it. The American Cancer Society estimates that this year, 230,900 new cases will be diagnosed and that about 29,900 men will die from prostate cancer.

    The walnut-sized prostate gland produces fluids that are contained in semen.
  12. by   Spidey's mom
    I admire folks who volunteer their time at great personal sacrifice and sometimes risk. My son leaves on a mission trip to Mozambique this summer to work at an orphanage. We've been on mission trips to Mexico helping to build playgrounds and ball fields and churches. My husband and sons cut firewood for folks around here who can't get their own. I think Mother Teresa was a lovely example of giving. My goal is to do medical missions work someday. BUT to equate that to volunteering to do a hand job on someone with a hard-on is just . . . .well, hilarious. What to call that volunteer organization . . . hmmm . . .. nope, can't go there.

    I'm not saying that sex isn't a wonderful part of life, but it isn't a necessity.

    As I said, there are resources for people who are disabled that help them have a safisfying sex life and have children if they wish. They don't need nurses in that equation.

    Wet dreams or the body's own physiology usually takes care of erections that remain unfulfilled. If not, there is medication.

    The prostate cancer study just out contradicts some previous studies that suggest that men who have frequent ejaculations might be more prone to prostate cancer due to exposure to germs and viruses. Well, that is great news but has little to do with the original scenario . . . nurses relieving a patient of an erection.

    As to the Dutch comment . . . . it was simply to make a point that it doesn't matter to me what other countries do - I think it is wrong to ask a nurse to provide this service and I would never do it. I didn't mean to leave anyone out.

    steph
  13. by   Roland
    I also think it is wrong to ask a nurse or doctor to do this sort of thing. That is why no one has suggested that as a solution. What is wrong with letting those who WILL do this sort of thing (prostitutes, volunteers, or mechanical devices) be utilized? I don't wish to be contentious, but like Bill O'Reilly I want the question to be addressed directly without spin. Even if I concede that it is only a "quality of life issue", why isn't that sufficient? What gives you or anyone else the right to prevent such a person with disabilities from seeking to get WILLING professionals (or volunteers, or technology) to maximize their quality of life? How are nurses or doctors any more affected by this than if the residient received a similar "visit" from a spouse or significant other? What makes such relationships acceptable in the context of a girlfriend, boyfriend, or marriage, BUT NOT acceptable when offered from one of these other "modalities" (even if you WERE going to take a MORAL/ religious approach then you would have to concede that both sex outside of marriage AND prostitution/ mechanical technology stimulation and/ volunteers were ALL sinful acts therefore all should be prohibited on that basis equally).
    Last edit by Roland on Apr 7, '04

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