Sexuality and a Severely Brain-Injured Spouse (Case Study) (Report‪)‬

Mrs. Z is a twenty-nine-year-old woman who sustained a severe traumatic brain injury five years ago when she was hit by a car whose driver was drunk. She spent six months recovering, first in the hospital and then in a rehabilitation facility. Since her discharge from the rehabilitation facility, she has been living at home with her husband and her four-year-old twin sons. Mrs. Z is unable to speak, dependent in all mobility and personal care, incontinent, and has a feeding tube. Although alert and able to respond to visual, auditory, and tactile stimuli, Mrs. Z is clearly unable to participate in even basic decisions. She requires twenty-four-hour care. A few months ago, Mrs. Z suffered abdominal discomfort, and her doctor discovered that she was pregnant. The pregnancy was terminated after physicians consulted on her case and determined that continuing it would compromise her health. Mrs. Z's parents are deceased, but her two older brothers have accused Mr. Z of rape. They contacted the local police asking that criminal charges be filed and have retained a lawyer to begin guardianship proceedings. Based on their sister's severe cognitive impairments, they do not believe that Mrs. Z can make any reasonable sense of what is happening to her and think that any sexual contact with a minimally conscious woman is inappropriate. They believe Mr. Z is abusive and his views self-serving.