Crime Today News
Justice secretary Shabana Mahmood is looking into a potential “national rollout” of chemical castration for sex offenders. This is a process of lowering testosterone levels with the intention of reducing libido.
The proposal is one recommendation outlined in the recent independent sentencing review that was commissioned to investigate prison overcrowding and consider alternatives to imprisonment. The review found that 21% of adults serving immediate custodial sentences had been convicted of sexual offences – making them a significant proportion of the prison population. The idea appears to be that chemical castration would make offenders’ release from prison less dangerous for the public.
A pilot scheme of voluntary chemical castration is already running and is about to be extended to 20 British prisons. But while the review emphasised that consent is a key tenet of medical law, Mahmood is reportedly investigating whether chemical castration could be made mandatory. This raises important ethical and legal questions.
Is it ethical?
Chemical castration is a dual-purpose intervention. It can be used both to benefit those who receive testosterone-reducing substances – sex offenders may themselves find their sexual desires to be a problem and so wish to have their intensity reduced by medical means – and to protect the public.
One key question, therefore, is what we are aiming to achieve in a programme of chemical castration in the prison population. Chemical castration may reduce the risk of reoffending but fail to improve a sex offender’s life. It may do the opposite – improving their wellbeing without protecting the public from their actions. Which goal are we aiming for?
This matters because the ethical permissibility of chemical castration is directly related to its purpose. Standard medical interventions are typically ethically permissible when and because they are expected to benefit recipients who validly consent.
If the goal is not to benefit the recipient but to protect the public, this question is more complicated. We don’t normally get to consent to being incarcerated or quarantined, for example. These are situations imposed on us by the state. So do we get to bypass consent in the case of chemical castration for people who are incarcerated?
And while some offenders may prefer to have their problematic sexual desires suppressed, chemical castration can have significant side-effects, including weight gain and mood changes.
If chemical castration does reduce problematic desires, sex offenders may benefit from it, side-effects notwithstanding. But it is unclear exactly how this potential “benefit” should be understood. Is it beneficial for sex offenders to have their sexual desires attenuated? Does avoiding future punishment itself count as a benefit? Can it also be beneficial to offenders who do not consent to the intervention? And is it ever ethically permissible to provide chemical castration without benefit to the recipient? We need a more clearly articulated understanding of benefit, and its interaction with consent, to determine when chemical castration is ethically permissible.
Is it legal?
Purpose also matters for legal justification. Interventions that use medical means – as chemical castration does – are usually lawful, again, because they are expected to benefit recipients. So, again, the lack of clarity over who “benefits” and how benefit should be understood is a problem.
My analysis of the legal framework in England and Wales shows that providing chemical castration to sex offenders may be consistent with obligations imposed on UK public authorities under the European Convention on Human Rights (via the Human Rights Act 1998). This may be the case even without recipients’ consent, especially when the purpose is public protection. But here too, it is necessary to clarify how the benefit or harm interacts with consent.
A dilemma for doctors
A rollout of chemical castration to sex offenders – whether voluntary or mandatory – also raises ethical and legal dilemmas for the people administering the programme.
Forensic psychiatrist Professor Don Grubin has said that the administration of chemical castration is “about doctors treating patients, rather than doctors doing a job for criminal justice agencies, but a side effect is that reoffending is likely to be reduced”. However, it’s not clear that chemical castration should always be understood primarily as “doctors treating patients” in the way we normally expect for therapeutic interventions.
The idea that doctors, in administering chemical castration, are always acting primarily to benefit the recipient, and that public protection in the form of reduced recidivism risk is a mere side-effect obscures the ethical and legal issues at play. A better approach is to clarify the different values and duties at stake and how doctors and others involved in provision should weigh them against one another.
Chemical castration will often generate conflicting duties, which we must find ways to navigate. Can it be compatible with professional obligations to provide interventions that aren’t in recipients’ clinical interests if it benefits others? Do professional obligations vary according to an intervention’s purpose? Chemical castration exposes tensions in the ethical and legal obligations that individual and institutional providers owe to recipients and to society.
I’m exploring these questions in research investigating how we ought to understand, evaluate, and regulate dual-purpose interventions. These are questions the government, and those involved in chemically castrating sex offenders must also confront.
Lisa Forsberg is Senior Research Fellow, Uehiro Oxford Institute, University of Oxford.
This article was first published on The Conversation.
📰 Crime Today News is proudly sponsored by DRYFRUIT & CO – A Brand by eFabby Global LLC
Design & Developed by Yes Mom Hosting
