{
  "schema_version": "uw.editorial_geo.v1",
  "route_id": "AGE-033",
  "article_index": "AGE-033",
  "catalog_id": "AGE-033",
  "material_id": "UW:AGE-033:en",
  "language": "en",
  "revision": 1,
  "master_revision": 1,
  "expected_revision": 0,
  "master_filename": "ARTICLE_EN.md",
  "master_sha256": "56066c4efd875e763697f090efdbe98dc7d1600d28d6214ffeba8b2c95a3a6ea",
  "headline": "Intimacy and consent with cognitive changes",
  "description": "A cognitive diagnosis certifies neither capacity nor incapacity to consent. Intimacy requires both participants’ present clear consent: do not initiate sexual activity without it, and stop at reluctance. Significant uncertainty/risk needs appropriate professional/local support; essential care is no price for intimacy.",
  "short_answer": "A cognitive diagnosis certifies neither capacity nor incapacity to consent. Intimacy requires both participants’ present clear consent: do not initiate sexual activity without it, and stop at reluctance. Significant uncertainty/risk needs appropriate professional/local support; essential care is no price for intimacy.",
  "claims": [
    {
      "id": "C01",
      "type": "bounded_diagnosis",
      "text": "Diagnosis alone certifies neither capacity nor incapacity to consent. Adult dignity and a particular decision differ; age, marriage or a good unrelated conversation does not answer for someone.",
      "article_sections": [
        "I. Diagnosis does not answer every question for someone"
      ],
      "source_ids": [
        "S1"
      ],
      "attribution": "Bounded source use plus editorial reasoning; RESEARCH.md",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    },
    {
      "id": "C02",
      "type": "bounded_consent",
      "text": "Do not initiate sexual activity without clear consent; stop at reluctance. Both participants need consent now and for the particular action; past answers, arousal or no resistance create no default permission.",
      "article_sections": [
        "II. Consent concerns the action, time and both participants"
      ],
      "source_ids": [
        "S1"
      ],
      "attribution": "Bounded source use plus editorial reasoning; RESEARCH.md",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    },
    {
      "id": "C03",
      "type": "bounded_uncertainty",
      "text": "Significant uncertainty needs appropriate professional/local legal routes. No home questionnaire, selected convenient hour for self-certification or authority for conversation supporters to consent for another is supplied.",
      "article_sections": [
        "III. Uncertainty needs support rather than a household certificate"
      ],
      "source_ids": [
        "S1"
      ],
      "attribution": "Bounded source use plus editorial reasoning; RESEARCH.md",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    },
    {
      "id": "C04",
      "type": "editorial_forms",
      "text": "Affection, sexual activity and personal care have separate conditions. Touch is no prescribed calming intervention; essential help is no price for intimacy.",
      "article_sections": [
        "IV. Affection, sexual intimacy and personal assistance differ"
      ],
      "source_ids": [],
      "attribution": "United Wisdom editorial reasoning",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    },
    {
      "id": "C05",
      "type": "bounded_partner_limits",
      "text": "Partners retain feelings, consent and limits. Care creates no sexual gratitude debt; partnership creates no endless resource or required reconciliation with an unsafe role.",
      "article_sections": [
        "V. Partners retain feelings and limits"
      ],
      "source_ids": [
        "S2"
      ],
      "attribution": "Bounded source use plus editorial reasoning; RESEARCH.md",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    },
    {
      "id": "C06",
      "type": "editorial_privacy",
      "text": "Family embarrassment does not replace participants’ voices. Privacy certifies no consent and does not remove the need for appropriate protective contact during risk; information, roles and authority need particular tasks and applicable local routes.",
      "article_sections": [
        "VI. Privacy is neither family permission nor a family trial"
      ],
      "source_ids": [],
      "attribution": "United Wisdom editorial reasoning",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    },
    {
      "id": "C07",
      "type": "bounded_protection",
      "text": "Suspected abuse needs an appropriate protective destination without household proof; immediate danger needs local emergency services. New sudden confusion requires immediate emergency medical help rather than an initial consent discussion.",
      "article_sections": [
        "VII. Suspected abuse needs protection, not household proof"
      ],
      "source_ids": [
        "S3",
        "S4"
      ],
      "attribution": "Bounded source use plus editorial reasoning; RESEARCH.md",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    },
    {
      "id": "C08",
      "type": "editorial_professional",
      "text": "Convey a particular question/facts without a completed diagnosis/consent conclusion. No medicine selection/concealed administration or training someone to agree; request/assessment/help differ, children are no mediators/interpreters.",
      "article_sections": [
        "VIII. Professional requests need a particular subject"
      ],
      "source_ids": [],
      "attribution": "United Wisdom editorial reasoning",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    },
    {
      "id": "C09",
      "type": "bounded_comparison",
      "text": "Shakespeare’s constancy and Mill’s limits on compulsion have different grounds. Poetry supplies no permanent consent; Mill’s historical exclusions are not adopted as dementia assessment or adult-child equivalence. No shared clinical mechanism or legal certificate.",
      "article_sections": [
        "IX. Constancy and voluntary participation have different grounds"
      ],
      "source_ids": [
        "S5",
        "S6"
      ],
      "attribution": "Bounded source use plus editorial reasoning; RESEARCH.md",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    },
    {
      "id": "C10",
      "type": "editorial_result",
      "text": "Stopping an unagreed action cancels neither relationships nor essential help. One clear moment certifies neither capacity for every decision nor clinical improvement; the next step needs actual arrangements without a convenient answer as payment.",
      "article_sections": [
        "X. The next step must not depend on a convenient answer"
      ],
      "source_ids": [],
      "attribution": "United Wisdom editorial reasoning",
      "limitations": [
        "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
        "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
        "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
        "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
        "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
        "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
        "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
        "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
      ]
    }
  ],
  "questions": [
    {
      "id": "Q01",
      "q": "Does marriage preserve consent to everything?",
      "a": "No. Past answers do not replace today’s. Both participants need clear consent to a particular action; stop at reluctance.",
      "claim_ids": [
        "C02"
      ],
      "source_ids": [
        "S1"
      ],
      "article_sections": [
        "II. Consent concerns the action, time and both participants"
      ]
    },
    {
      "id": "Q02",
      "q": "Does diagnosis automatically rule out all intimacy?",
      "a": "No. It does not itself determine capacity; significant uncertainty needs individual professional/local routes.",
      "claim_ids": [
        "C01",
        "C03"
      ],
      "source_ids": [
        "S1"
      ],
      "article_sections": [
        "I. Diagnosis does not answer every question for someone",
        "III. Uncertainty needs support rather than a household certificate"
      ]
    },
    {
      "id": "Q03",
      "q": "Start and use the reaction to check desire?",
      "a": "No. Do not initiate sexual activity without clear consent; arousal and no resistance create no default permission.",
      "claim_ids": [
        "C02"
      ],
      "source_ids": [
        "S1"
      ],
      "article_sections": [
        "II. Consent concerns the action, time and both participants"
      ]
    },
    {
      "id": "Q04",
      "q": "Can a questionnaire or good conversation certify capacity at home?",
      "a": "No. This article supplies no test/conclusion; significant questions need appropriate competence and local procedures.",
      "claim_ids": [
        "C03"
      ],
      "source_ids": [
        "S1"
      ],
      "article_sections": [
        "III. Uncertainty needs support rather than a household certificate"
      ]
    },
    {
      "id": "Q05",
      "q": "Must a caregiving partner accept intimacy for the other?",
      "a": "No. Both retain consent and limits; support is not bought through unwanted action.",
      "claim_ids": [
        "C02",
        "C05"
      ],
      "source_ids": [
        "S1",
        "S2"
      ],
      "article_sections": [
        "II. Consent concerns the action, time and both participants",
        "V. Partners retain feelings and limits"
      ]
    },
    {
      "id": "Q06",
      "q": "Does stopping intimacy cancel essential assistance?",
      "a": "No. Essential needs still require actual assistance; care is no price for permission or the right reaction.",
      "claim_ids": [
        "C04",
        "C10"
      ],
      "source_ids": [],
      "article_sections": [
        "IV. Affection, sexual intimacy and personal assistance differ",
        "X. The next step must not depend on a convenient answer"
      ]
    },
    {
      "id": "Q07",
      "q": "Prove abuse at home before reporting concern?",
      "a": "No. Give the particular concern to an appropriate protective recipient; immediate danger needs local emergency services.",
      "claim_ids": [
        "C07"
      ],
      "source_ids": [
        "S3",
        "S4"
      ],
      "article_sections": [
        "VII. Suspected abuse needs protection, not household proof"
      ]
    }
  ],
  "sources": [
    {
      "id": "S1",
      "title": "Alzheimer’s Society Consenting to sex and intimacy after a dementia diagnosis; reviewdate unknown",
      "url": "https://www.alzheimers.org.uk/get-support/living-with-dementia/sex-health-dementia",
      "read_scope": "Complete substantive187/208–240 read; particular/time/clear bothpartner consent/stop/arousalnotconsent. EnglandWalesMCAcriteria read but not imported as home test or current local law. Relatedcarddates not review"
    },
    {
      "id": "S2",
      "title": "Alzheimer’s Society Maintaining your relationship after a dementia diagnosis; reviewdate unknown",
      "url": "https://www.alzheimers.org.uk/get-support/living-with-dementia/maintaining-relationships-dementia",
      "read_scope": "Complete substantive209–235 read; roles/bothfeelings/support/unsafe care not compulsory. No prescribed reconciliation, counselling, sleep/devices or foreignserviceentitlements"
    },
    {
      "id": "S3",
      "title": "Alzheimer’s Society What to do if you suspect sexual abuse; reviewdate unknown",
      "url": "https://www.alzheimers.org.uk/get-support/living-with-dementia/sexual-abuse-dementia-advice",
      "read_scope": "Complete substantive187/209–217 read; appropriate protectivecontact/privacy/dignity, not home investigative/capacity checklist or global criminal law. Localimmediatedanger response editorial boundary, no foreignnumber"
    },
    {
      "id": "S4",
      "title": "NHS Sudden confusion; reviewed2024-05-28",
      "url": "https://www.nhs.uk/symptoms/confusion/",
      "read_scope": "Complete main actually read underAGE027; immediate local medicalcontact reused, no new fullreading/consenttest/cause claim"
    },
    {
      "id": "S5",
      "title": "William Shakespeare Sonnet116, Folger",
      "url": "https://www.folger.edu/explore/shakespeares-works/shakespeares-sonnets/read/116/",
      "read_scope": "Complete14lines303–316/synopsis299–301 read after initialmetadata-only retrieval repaired. Constancy no permanentconsent/abuse/care duty, not entirecollection"
    },
    {
      "id": "S6",
      "title": "John Stuart Mill OnLiberty chapterI, Gutenberg34901",
      "url": "https://www.gutenberg.org/files/34901/34901-h/34901-h.htm",
      "read_scope": "Complete selectedparagraphs200–222 read; coercion, historicalqualifications including paternalistic/colonialexclusions, utility/participation. Not wholechapter/book. Exclusions not endorsed/transferred to dementia/moderncapacitylaw. USApublicdomainlabel not worldwideclearance"
    }
  ],
  "retrieval_limits": [
    "Fictional adultMira/Sergei known dementia, no current abuse/suddenconfusion/immediate danger.",
    "No home diagnosis, capacity score/questionnaire/test or certification by memory/gesture/convenient timing.",
    "No consent by marriage/past/arousal/silence/no resistance; significant unknowns are no permission.",
    "No foreign law applied universally. EnglandWalesMCA2005description read is neither a home algorithm nor current local legal acceptance.",
    "No intimate procedure, sexual technique, coercion, medicine change/concealed administration, restraint or independent sedation.",
    "No gratitude debt/unwanted intimacy for care, withheld essential help, required reconciliation or child mediator/interpreter.",
    "No public intimate dossier, absolute secrecy where protection needed or report confined to possible source of risk.",
    "S1/S2/S3reviewdatesunknown, relatedcarddates not review. Native/independent/clinical/legal/production acceptance NOT_RUN."
  ],
  "production_contract_status": "NOT_RUN; editorial representation, not validated Machine Publisher payload",
  "production_acceptance": "NOT_RUN",
  "schema_org": {
    "@context": "https://schema.org",
    "@type": "Article",
    "identifier": "UW:AGE-033:en",
    "headline": "Intimacy and consent with cognitive changes",
    "inLanguage": "en",
    "author": [
      {
        "@type": "Person",
        "name": "Andrey Zarinsh"
      },
      {
        "@type": "Person",
        "name": "Maria Evilkut"
      }
    ]
  }
}