Safeguarding : Incest

Some of my readers are aware that I am an Adult Safeguarding Nurse for a large hospital in the south of England. This work leads to a lot of exposure to (among other things) the weird and wonderful diversity of human nature. I will relay some of the more interesting experiences in these posts if it is possible to anonymise the details enough to prevent a breech of confidentiality. In the case of this post I have changed some of the smaller details which don’t in any way impact the learning I have taken from it.

I received a call for advice from a department in the hospital regarding a patient in her early twenties who reported to being in a consensual sexual relationship with her biological father who was in his late thirties. Realistically this does not constitute a safeguarding concern as defined by Section 42 of the Care Act(2014) given neither individual was considered to have a cognitive impairment that would suggest an exploitative relationship. However as rule anything that doesn’t really fit anywhere else comes to my team. and I am going to be honest the research necessary for this case has fucked my browser history up and I am really looking forward to how it impacts my targeted adverts on sites.

My immediate reaction when the basic details were described to me was “ewwww” however that was a very quick instinctive reaction which led to me thinking “blimey, that felt like a programmed response”. I did some digging and stumbled across a psychosocial mechanism called The Westermark Effect. This is sort of like a a reverse imprinting from a young age. Sexual attraction is suppressed with people you live closely with, this is believed to be a clever biological mechanism to limit the damage inbreeding can do to any gene pool. I am from Cornish stock, my people are famous for inbreeding on a borderline industrial level however its usually not immediate family members. As a professional this led me to wonder how effectively I could support these patients given I am biologically programmed with a bias preventing me from understanding their situation.

There were some obvious human rights and criminal considerations so the obvious place to start was Section 64 of the Sexual Offences Act(2003). This led to a number of interesting incidental findings –

  1. Adoptive family are covered by this section. I presumed the reason for the Act was to legislate in a way that would prevent damage to the gene pool and prevent the birth of children with potentially avoidable life limiting physical health problems. Which thinking about it feels like legislating for Eugenics. However preventing intercourse with an adoptive family member who in theory has no genetic tie to you doesn’t fit that theory so I have no idea of the aim of this section.
  2. My patients believed they were not breaking the law because they apparently didn’t have penetrative vaginal intercourse, only anal and oral sex. It turns out according to the Act any sexual penetration is unlawful. Which again doesn’t support the theory that the purpose of the section is to protect against the consequences of a close familial pregnancy.
  3. The punishment for violation of this section is a custodial sentence of not more than eight months AND a fine OR a custodial sentence of not longer than two years.

This got me wondering how many people have actually been prosecuted under this section of the Act. I found a response to a freedom of information request submitted to the Crown Prosecution Service(CPS) indicating that between 2003 and 2017 eighteen people have been prosecuted. This doesn’t include arrests without prosecution. I know this is over a period of fifteen years but that was still considerably higher than I was expecting. I do however remember listening to a podcast which outlined a situation with some similarities to the case I had. I think it was RedHanded but I am afraid I cant remember which episode. However I do highly recommend this podcast, it is truly outstanding.

So the next question that presented itself was – Is legislating against sexual relationships with close family members a violation of a persons rights under the European Convention on Human Rights(ECHR) or the Human Rights Act(1998). The key article in question would be Article 8, the right to a private and family life. Honestly I have no answers here. In my work I assess situations against Article 5 (The Right to Liberty and Security) and Article 8 (The Right to a Private and Family Life) on almost a daily basis. If the spirit of the law was to protect society and the well being of hypothetical unborn children I would argue there is no violation in legislating against incest. However for the reasons listed above I have no idea what the spirit of this act is but it doesn’t appear to be about protecting genetic diversity or unborn children.

This case has offered a lot of reflection and learning. Both academically and in considering how I as a person respond to situations that I don’t understand or that don’t conform to even the broadest social-norms. I would totally invite discussion and debate around this issue.


  1. Very interesting read! I too automatically thought ‘eww’ – I am shocked to hear that neither parties have any cognitive impairment!

    1. They seemed intelligent, insightful caring people who were genuinely in love. Its wierd how social norms create these biases in how we see the world. i wonder how many of my actions and reactions are the result of a programmed bias rather than conscious and impartial thought.

  2. This is an interesting article!
    The majority of law in England stemmed from biblical principles. One passage in Leviticus (18: 6-12) seems to be the closest to denouncing blood related sexual activity. This however is contradicted with the story of Lot’s daughters (in Genesis 19:30-38) who without consent it seems slept with their father to carry on the family name. Admittedly there is no comment regarding whether Lot or God approves / disproves of this particular union.
    Whilst the comment doesn’t solve the posed question I think it adds another dimension to the conversation.

    1. I have a technical knowledge of Christianity but despite the best efforts of various people in my life I am not “of the faith”. It still blows my mind to accept at one time or another we were mostly a theocracy.

      I have to admit I was reviewing Section 64 of the Sexual Offences Act(2003) from a purely biological and ethical stand point. I hadnt considered the possibility of a religious hangover. Are there any other laws that are explicitly drawn from religious doctrine?

      I was recently working on some Henry VIII stuff and I know one of the issues that as raised about his marriage to Catherine of Aragon(given that she was his brothers widow) was Leviticus 20:21. It was claimed that his marriage displeased God which is why his son died after only weeks and his only other child with Catherine was a boy without a winkle.

      1. So I had a long think about this and the following comment is a more a thought than steeped in evidence. It also doesn’t answer any of your questions or potentially relate much to my previous comment. So sorry about that.
        It seems that what we know in the western world as law follows the evolving collective thoughts of human values, current knowledge and belief systems. What is perceived as morally wrong or right is usually influenced by the belief systems of the current era of the time. Humans then sought to embellish that with probably selective “evidence” be it religious texts, musings from thinkers or otherwise loud influential or socially powerful groups / people.
        At one point in history religious text was taken for the one universal truth. We now live in a society than has been taken some of those previously known “truths” and added it to research, science and more importantly an appreciation of the human lived experience.
        In short the law may be the sum and total of what the majority of humans subscribe to as acceptable and is subject to change dependent on if there is enough people to challenge the perception or law.

        1. In judaism a lot of laws as determined in the Talmud were devised by the Sanhedrin, a council of 23 leaders. They were one of the first to really think about things like capital punishment. If someone comitted one of the very few capital offences their punishment had to be ratified by the Sanhedrin. I personally dont agree with capital punishment however if it has to exist requiring it to be debated and ratified by 23 people is a pretty solid way of ensuring its properly explored.

          I know the Church have also ahd a lot of say in legal development for a couple of reasons, in medieval and pre-conquest England the only people you were likely to find around who could read and write your laws were the clergy. Theres also the concept of rule by Divine right, most rulers wanted to keep the church happy because fear of displeasing Gods appointed king prevented a lot of insurrection. If you want an example of how powerful the church became in legal doctrine take a look at the Magna Carta, originally signed in 1215 forcing reconsilition following very specific greivances by the Barons against the King, huge amounts of this document benefit and protect the church. So even laws that havent come directly from religious doctrine are heavily influenced by religion.

  3. In regards to the issue of confidentiality I touched upon, in true HCP fashion a number of people appear anxious. Firstly i’ve not explicitly stated which hospital I work for, although it wouldn’t be too hard to work out. I have deliberately given vague information, my work was all about the patient, this write up is about the theme. So depending on which hospital I work at I could have between 500 and 2500 inpatient beds, I’ve not stated which department this individual was in so lets say around 10,000 outpatients are seen on any given weekday across the South Coast of England thats not including Emergency Departments (because I have no idea how to find those numbers). I have given no clues to the patients ethnicity, height, hair colour, date of birth or even geography (beyond south of England). The only information I have given may well have been tweaked. I would be surprised if the patietn read this herself recognised herself in it. I have published this with absolute confidence that I have not breached any professional standards. I also moderate all comments before publishing.

    I hope thats put some minds at rest. I worry that fear of information governance prevents us, particularly in health and social care from having important conversations. The Data Protection Act(2018) is a tool to ensure the appropriate and safe use of information. It does not demand censorship over vague discussions about patients where the patient has been rendered entirely unrecognisable.

  4. Richard, you know me well enough to know I am not intelligent enough to debate or really comment on things you have to say 🤣. However…… my first reaction was yuk! But I do have a few follow up questions if they can be answered without disclosing any confidential information…..
    firstly did the daughter grow up with her her father or meet him as an adult and then start a relationship?
    Secondly, although although there is apparently no cognitive impairments, could the daughter have been groomed from a young age?

    1. Very sensible questions. I can broadly answer, they had lived together all their lives, they reported the relationship only started in the last year and we had no evidence to contradict that. Im guessing you were considering the Genetic Sexual Attraction (GSA) phenominon.

      I strongly suspext there may have been an element of trauma bonding.

  5. I dont know if its the Baader-Meinhoff phenomenon but since this case and writing this post I have become aware of three similar cases locally. Is incest more common than I thought? Interestingly the penalties range from nothing to four years in prison. Everything seems contingent on when the relationship started(after the age of eighteen or before) and is there is any suspicion of prior grooming.

    Whilst this is fascinating I am not sure it is something I want on my cognitive radar.

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