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Sexual implications The nature and degree of impairment in sexual functioning after injury to the spinal cord will depend upon the level and the completeness of the lesion. With a complete lesion paraplegic men will rarely experience ejaculation, although orgasm can occur with this. Some have referred to this as a 'phantom orgasm', while others argue that orgasm as such is a central event and does not depend for its occurrence upon peripheral responses (Geiger, 1979). Male paraplegics will generally be able to achieve a reflexogenic erection, but not a psychogenic one and the erection may be difficult to maintain. Less is known about the sexuality of spinal cord injured women http://www.judis.nic.in than that of men (Thornton, 1979). Vaginal lubrication may still occur as a response to stimulation, and orgasm, as in men. A woman's fertility is not affected, although child-bearing and labour will be more difficult; most men, in contrast, will find that their fertility is severely impaired. The act of intercourse itself is complicated by the spinal cord injury, whichever partner is the injured one. There will be limitations in the positions that can be adopted; involuntary spasms may occur and incontinence, or the management of an indwelling catheter, can be a problem also. Little is known of the psychological impact of sexual dysfunctions. Some commentators have suggested that patients are more concerned about these than about any other aspect of their disability (Bloom, 1974; Breslin, 1971; Cole et al., 1973), but this may overstate the case. In one study paraplegics rated sex the least of the major functional losses resulting from their injury; 52 per cent thought the loss of the use of their legs the most important, 35 per cent the loss of control over bowel or bladder, and only 13 per cent the loss of sexual functioning (Hanson and Franklin, 1976). Furthermore, in long term relationships sexual difficulties may be of secondary importance compared with other problems such as loss of fertility (David et al., 1978). Personal implications The difficulty that any particular individual finds in adjusting to the social, sexual and other implications of injury will depend in part upon the personal significance that these have for him or for her. No stress or crisis is uniform in its impact. This will depend upon how the situation is appraised within the framework of the individual's own life style and values (Lazarus, 1966). Thus a person whose sense of personal worth is centred upon their appearance or physical prowess might, other things being equal, be more greatly affected by injury than another whose focus in life is intellectual and non-active. The meaning of the injury at a more general level will also be important. For example, if it is seen (unconsciously or otherwise), as some kind of http://www.judis.nic.in punishment, then feelings of worthlessness may be enhanced (Simon, 1971). If, in contrast, it is associated with an act of bravery it may acquire a positive as well as a negative meaning; Katz and colleagues (1978) found that disabled war veterans had a more positive self image than people who had received their injuries in accidents at work. Disabled people, as a group, do have a poorer adjustment than the able-bodied (Wright, 1960). Those with spinal injuries often have emotional problems (Geis, 1972; Hohmann, 1966), have higher scores than normal on the Hypochondriasis, Hysteria and Depression scales of the M.M.P.I. (Bourestom and Howard, 1956), and may be more prone to self destructive behaviour and suicide (Hopkins, 1971)." Therefore, the appellant as well as the 2nd respondent have to be compensated for loss of marital bliss or reduction in marital bliss. Accordingly, a sum of Rs.2,00,000/- each, totally Rs.4,00,000/- is awarded to them under this head.