La autonomía y toma de decisiones: sexualidad en adultos con discapacidad intelectual leve desde una aproximación sistémica, compleja y ecológica.

Abstract

This research is conducted within the epistemological proposal of the Master of Clinical and Family Psychology from the Psychology, Family and Networks research group of the Department of Psychology. The line of research is psychology, human systems, and mental health, which is part of the macro project, Stories and Narratives of Human Systems in a Variety of Contexts, of the Master of Clinical and Family Psychology at the Universidad Santo Tomás. The study aims to recognize the dominant (religious and medical model) and emerging (functional diversity and rights approach) narratives of the main parties involved in the autonomy and decision-making on the sexuality of people with mild ID. This study was carried out through a state-of-the-art documentary research to answer the question: What are the dominant and emerging narratives of people with mild ID, family, caregivers, and health and education personnel regarding the autonomy and decision-making on the sexuality of people with mild ID? The theoretical system focused on the historical conceptualizations of disability and the concept of functional diversity. As a reference and analysis framework, the study utilized the theoretical proposal of complexity, constructionism, constructivism, second-order cybernetics epistemology, and the systemic and ecological model. This theoretical proposal considers parties as assets in the analysis of the research phenomenon, so that their discourse will facilitate an understanding of the current dominant and emerging narratives. A qualitative methodology was utilized to conduct this study, specifically a state-of-the-art documentary research. Based on the needs identified by the researcher’s professional experience, some categories were established including dominant narratives of disability, legal framework, disciplinary narratives, and narratives constructed from experience, autonomy, human rights, and self-management. These categories were analyzed transversally by the trends appropriate for a state-of-the-art documentary research, such as document type, discipline, chronology, country, research type and population. Among the significant findings of this study, the persistence of dominant narratives is highlighted, such as those from the medical-care model in the family, caregivers and health personnel’s discourses, in which people with mild ID have an abnormal and inferior condition and should be cared for, supporting the "eternal child" narrative. These discourses have historically limited and hindered people with mild ID from being independent and responsible for their lives. Nevertheless, the analysis of documents about this phenomenon written in the last decade, showed a growing development of regulations and legislation that recognize people with ID as subjects of rights. These positions present emerging narratives, which have been created due to epistemological models, such as the systemic and ecological model. These models have led to the construction and recognition of new realities like more inclusive and enabling models, breaking dominant concepts and categories, which result in subjective experiences.