LiveSmart: Reframing Consent – Promoting Mutual Respect, Boundaries and Open Communication

[This story was written by Alexa Cappola, LMSW, a social worker with St. Peter’s Crime Victim Services.]

April marks both Sexual Assault Awareness Month and Crime Victims’ Rights Week, April 18-24. The importance of consent when providing care to patients/clients, in order to protect and respect their rights, is a topic regularly discussed among clinicians.

While we always strive for written consent, clinicians also require verbal and non-verbal consent throughout their interactions. For example, although a physician will have prepped their patient for a procedure, they may ask repeatedly during the interaction: “Does that feel all right?,” “Are you okay to proceed?,” or “How are you feeling?”

If the physician notices the patient looks confused or in discomfort, they may stop and ask if they need clarity or a break. If a client flinches or pulls away, doctors will stop the procedure rather than continue with force. Even when they are not explicitly asking “Do I have consent to proceed?” the caregiver is still seeking affirmative consent through their use of language and open communication.

The same rules can be applied outside of healthcare. When it comes to personal relationships, dating and discussing sexual activity, consent is crucial. While definitions vary, consent in its most basic terms means to give permission.

Within recent decades, policies pioneering both affirmative and enthusiastic consent have been adopted across various states and agencies. Conversations about affirmative consent arose in the early 1990’s when Antioch College in Ohio adopted a rigorous affirmative consent policy that required students to seek enthusiastic verbal consent before any sexual interaction(s). This replaced “no means no,” when consent is only withdrawn after an individual clearly says “no,” with ”yes means yes.”

While initially mocked, that policy has since become widely adapted nationwide. In 2015 New York state representatives passed “Enough is Enough” legislation that required campuses to adopt guidelines under a uniform definition of affirmative consent.

Many affirmative consent policies also include enthusiastic consent. While affirmative consent is to ensure all parties are knowingly and voluntarily engaging in a sexual activity, enthusiastic consent ensures your partner(s) are comfortable throughout the interaction. Under no circumstances can a person give consent when they are being coerced, forced or pressured, underage, or if they are intoxicated/incapacitated.

RAINN defines consent as “an ongoing process of discussing boundaries and what you’re comfortable with.” Consent is always voluntary and can be withdrawn at any time. Consent once does not mean consent always, and it is important to be mindful of your partner’s needs through verbal, non-verbal, and virtual communication.

St. Peter’s Crime Victim Services offers free and confidential services to survivors of crime. Available services include medical and legal advocacy, short-term counseling, therapy, and compensation assistance. For more information, please call 518-271-3410 or visit us at If you have been assaulted or urgently need to speak with someone outside of business hours, please contact our 24-hour hotline at 518-271-3257.

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