Consent for Spiritual Care: Adjusting the Vulnerability and Power Imbalance for Persons with Intellectual Disabilities

Abstract

In the past, we offered spiritual care to people with intellectual disabilities without asking their consent. Today we can no longer justify this practice, not only because of developments in society, but also because the spiritual care relationship is characterized by an inequality in vulnerability and dependency, leading to an inequality in power. Seeking informed consent is precisely an important way to adjust this vulnerability and power imbalance. We therefore explore the different forms of consent as well known in health care, in particular current, prior, and proxy consent. However, their use is limited in spiritual care with people with intellectual disabilities. That is why we propose a relational and integrated approach to consent: in the dialogue between all those involved, we strive for shared decision-making by combining the different forms of consent. Important in this respect is the proposal of ‘inferred’ consent, whereby during the process of spiritual care, we actively infer consent or refusal from the words and behavior of the person with intellectual disabilities.

Keywords:

• Consent
• spiritual care
• intellectual disabilities
• vulnerability
• power

Disclosure statement

No potential conflict of interest was reported by the authors.