By Rose Bowen and Michael Lausberg

In cases of sexual assault, the issue of consent is of central concern. Establishing that consent was freely and affirmatively given is not always easy. A sexual assault case in Iowa highlighted one such dimension of this complicated issue. Henry Rayhons was accused of sexually assaulting his wife, Donna Lou Rayhons. Henry insisted that the sexual contact was consensual, but the prosecuting attorneys claimed that Donna’s dementia made her incapable of giving consent. Henry was arrested last summer, just a week after his wife passed away.

Henry and Donna met after the deaths of their respective long-time spouses, and were married less than two years later. Friends and family recall that they were an extremely happy couple. A few years into their marriage, Donna was diagnosed with early onset Alzheimer’s disease, a form of dementia. She deteriorated rapidly over the next few years. She became increasingly forgetful, suffered from headaches, drove on the wrong side of the road, and, once, was found putting her hands into a toilet bowl at a restaurant. On March 29, 2014, her daughters Linda and Suzan decided to move their mother to the Concord Care Center in Garner, Iowa. They clashed with Henry over the decision; he wanted Donna to continue to live with him. In May 2014, the Concord staff recommended that Donna’s sexual contact be limited, due to a seemingly diminished capacity to give consent (she scored a zero on a cognitive test). The staff informed Henry of their decision. Henry testified that the staff did not order him to refrain from engaging in sexual activity with his wife, they simply advised him to exercise caution. Two weeks later, Donna’s roommates reported that Henry had engaged in sexual intercourse with Donna, a claim supported by video surveillance footage. The cameras showed Henry leaving Donna’s room with her underwear, which he discarded in a laundry basket. Suzan took Donna to the hospital for a rape exam. The results of the exam were inconclusive, but the state crime lab found semen stains on Donna’s quilt that matched Henry’s genetic profile. After being questioned, Henry admitted to having had “sexual contact” with his wife that day. Two months after this incident, Donna passed away.

Six days ago, the jury acquitted Henry of all charges. Prosecutors needed establish two facts to prove that this was a case of sexual assault: that Henry had had sex with Donna, and that she was incapable of giving consent. The defense cast doubt on both these charges.

The verdict in this case was anxiously anticipated, for Iowa law prohibits sex with a person suffering from a “mental defect or incapacity,” and this ruling would determine whether dementia could fall into this category.

While the evidence strongly suggested that Henry and Donna engaged in sexual intercourse, it did not establish that penetration was involved. And while the results of Donna’s cognitive test suggested that she was most likely suffering from a “mental defect or incapacity,” this too needed to be proven beyond reasonable doubt. Mental illnesses often do not follow a linear progression. Patients with Alzheimer’s disease are prone to moments of lucidity, during which time their ability to give free and affirmative consent seems undeniable. Douglas Wornell, a geriatric psychiatrist and specialist in the field of dementia, compares the sex drive to the basic need for food; he believes that it would be “naïve” to think that Donna’s cognitive test results could somehow exclude her from being able to consent to sexual intercourse. The questions the jury needed to consider in this case were weighty and complex: Is Donna’s cognitive test result an accurate reflection of her general mental state? Could a subpar test score require that Donna waive her right to engage in sexual relationships? On the other hand, not taking steps to prevent patients who suffer from dementia and other neurodegenerative disorders might open this population up to all sorts of abuse.

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