Intended for healthcare professionals


Personal services or dangerous liaisons: should we help patients hire prostitutes?

BMJ 2004; 329 doi: (Published 21 October 2004) Cite this as: BMJ 2004;329:985
  1. James Barrett, consultant psychiatrist (
  1. West London Mental Health NHS Trust

    Iwas first asked to see Mr Cooper (not his real name) in my capacity as a psychiatrist. The general practitioner's referral letter said he was a man in his 80s, frail, catheterised, demented, and displaying “inappropriate sexual behaviour.” I visited Mr Cooper at his local authority residential home.

    It seemed that Mr Cooper had persistently been asking female members of staff to have sex with him. The problems seemed to have begun when Mr Cooper's regular visits from an elderly female friend had ceased.

    Although rather deaf and undoubtedly frail Mr Cooper did not have significant cognitive impairment. He volunteered that his visitor had been providing him with paid sexual services, and that since this was no longer possible he wanted to hire another prostitute. He said his deafness and poor vision had now made it difficult for him to do this for himself, and he had consequently sought help from the staff. He had been firmly refused. I gathered that after a stalemate of many months he could think …

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