Respect for Intimacy Among Persons Whose Privacy Is Compromised.
Bibliographic record
Abstract
This invited commentary addresses an article by Joy and Weiss and their views on the potential use of sexual advanced directives "… as a theoretical mechanism to assert sexual desire past incapacity …." Their article focuses on the importance of the sexual rights of individuals with neurocognitive disorders, principally dementia, in which there is a progressive decrease in executive functioning leading to impaired communication, understanding, and judgment. Individuals with dementia may be increasingly challenged to maintain autonomy in life, such as in cases of financial decision-making, self-care, end-of-life care, and, as Joy and Weiss point out, decisions pertaining to sexual relations. They highlight a possible trend of placing increasing restrictions on the freedom of aging patients to have sexual intimacy, to ensure their safety, and to prevent the potential of sexual abuse or other forms of harm. They propose the development of a "hypothetical sexual advance directive" for those at risk for incapacity, in collaboration with forensic psychiatrists. Although we agree that sexual rights should be legally protected by the established principles of the right to govern one's own body, rights of privacy, and autonomy, we are concerned that the requirement to have a signed and witnessed sexual advance directive may have unintended consequences that decrease, rather than enhance the sexual rights of people with dementia and other types of intellectual disabilities. We propose an alternative in which established and consensual sexual intimacy is treated as an aspect of the right to bodily self-determination that should not require an advance directive.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.008 | 0.017 |
| Scholarly communication | 0.006 | 0.008 |
| Open science | 0.004 | 0.005 |
| Research integrity | 0.055 | 0.045 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".