Ethical considerations about consent as the core of sexuality

SummaryIntroductionThe notion of consent is more often associated with situations of sexual assault than with sexological studies and treatments in which the objective and the ideal of a “satisfactory sex life” relegates the idea of constraint to a position of secondary importance.ObjectivesOur intention in this article was to demonstrate that, from the point of view of the issues which might be raised in the field of sexology, the notion of consent covers more than the agreement between two people with regard to an unequivocal act or relationship. In sexological treatment, it even occupies a central position, both as an ethical question (which determines the position of the therapist and the patient) and as the content of the consultation (as something which implicitly underlines the complaints made).MethodAn analysis of the medical and sexological literature provides clarification in support of the clinical concept of “multidimensional consent”. Three examples taken from our clinic illustrate its relevance.ResultsWe suggest taking three “constants” explicitly into account in the clinic: the person's concept of the world, which, for the consultant, determines her perception of “normal sexuality”; the relationships of power, which form the basis of any situation in which persons come closer together; and negotiation, an inevitable prospect if any association is to be maintained.ConclusionFor the consultant, the route to “a satisfactory sex life” must necessarily take a person through an identification of what he/she has effectively consented to within the context, which forms the basis of her complaint. The sexologist will help this person through the attention given from the outset to these three constants, which form the structure of consent.