The Ethics of Intimacy Recovery

We embrace the Recovery Philosophy at Ontario Shores Centre for Mental Health Sciences (Ontario Shores).   Recovery applies to a person’s whole being; their mental, physical, social and spiritual aspects.  It works best in an environment that mirrors the community beyond the hospital walls where it is possible and reasonable.  To that end, Ontario Shores has established a suite called Our Place, where patients can engage in intimate activities – including sex, in a private and dignified way.

Talking about intimacy and sex can make us feel uncomfortable.  From a very young age, we’re warned about the bad consequences of sex and our society has taken great effort to develop measures that mitigate the physical risks. Despite the unease, it’s important to have conversations with patients about these risks. It’s equally important, if not more so, to help patients navigate the emotional twists and turns that come with intimate relationships.

We might be inclined to help patients avoid the stresses that accompany relationships, or we might feel responsible if a person’s recovery is affected by a painful experience.  However, we are reminded that a major part of the recovery philosophy involves supporting people to take appropriate risks.  Therefore, provided that no legal restrictions apply, voluntary inpatients age 16 and over are free to spend time in the intimacy suite with the partner of their choice.  Only if we have reason to believe that a person will be seriously harmed by engaging in sexual activity do we have a moral obligation to prevent them from accessing Our Place.  It is not appropriate to deny access because of marital status, sexual orientation, gender identification, or the character of the patient’s partner per se.

It is important to ascertain the patient’s capacity to engage in sexual activity with another person. The Ontario Shores policy on Consensual Sexual Behaviour of Hospitalized Patients states that “A person is capable of consenting to sexual activity if the person is able to understand information relevant to making a decision about sexual activity, and is able to appreciate the sexual nature of the act being consented to and both the immediate and longer term consequences of a decision about sexual activity.” A discussion to determine capacity will also be a good time to ask the patient about their values and hopes regarding intimacy, and the ways in which their recovery can be supported.

It’s normal to have a desire to prevent people from getting hurt, especially if we’ve been hurt ourselves.  Though wisdom can be transferred by well-intentioned advice, people often learn most effectively from their own experiences. We must accept that these experiences may cause pain, and we must remember that painful experiences can occur whether patients are inside or outside of the hospital.  Intimate relationships, and their attendant risks, are part of life and personal growth.  They provide opportunities to learn about one’s capacities, one’s emotions and one’s resiliency.  And don’t forget about the good parts! Intimacy and sex can bring great joy, closeness and meaning to a person’s life.  Certainly, the recovery philosophy embraces these positive and life affirming facets.

Ideally, there will come a time when it is no longer necessary to write about Intimacy Recovery; intimacy will be something that people will not lose in the first place.  Until then, patients can benefit from support for new and existing relationships, and from being enabled to enjoy this natural and important part of life.