Much in the press recently about the use of direct payments by disabled persons for sexual services. And very hot under the collar everybody is getting about it too. See Community Care, and again in Community Care and Care Space.
I have some direct experience of this (ahem - not that direct) in that whilst training as a lawyer, I was employed as a personal assistant for a physically disabled adult man who as a result of his disability found the whole issue of intimate relationships very difficult. I was paid by direct payments. In the course of my employment we had many debates about the ethical and legal issues surrounding the 'what ifs' of him paying for sex, when he could not achieve this without the assistance of his employees to transport him. We never reached a conclusion: it is pretty intractable.
A severely physically disabled person's need for sexual fulfillment, his right to privacy and to family life is necessarily impinged upon by his practical day to day care needs, and there is often a conflict or tension between the rights of the disabled person and the legal rights of his carer or assistant as employee. This is one such area. And of course overlaid upon that are the legal and ethical difficulties with the often exploitative sex industry.
My debates with my boss tended to move in circles and never reached resolution, but for my part I kept coming back to the question of why, if the exploitation of women through the sex industry is wrong, we should suspend that tenet simply because the person purchasing the sex is disabled. That does not bely a lack of understanding for how a disability can make forming relationships much more difficult (or can make sexual acts practically very difficult to achieve), but I don't think that you can abandon the rights of one group in favour of another: the potential consequences for women abused and exploited as a consequence of the sex industry are far more grave than the consequences of not finding sexual fulfillment, which many people both disabled and able bodied have to deal with in their lives. I don't think that there is an easy solution to this debate, but perhaps the provision of regulated and legal services to those with disabilities (sex therapy?) may be part of it, along with support to ensure that those with disabilities are able to integrate better socially and therefore are supported in forming relationships like the rest of us?