Tuesday, July 22, 2008

Is So-Called Chemical "Castration" for Sex Offenders Morally Licit? [UPDATED]

I don't know the answer (but tend to think perhaps not, while nevertheless remaining open to hearing the arguments either way), but Mark Shea seems to think the issue is a slam dunk "NO":

I eagerly await the finely parsed exegeses in my comboxes explaining, not only that castration is acceptable for rapists, but that hand amputations are suitable for thieves, tongue branding or removal is justice for slanderers, and foot removal is the due penalty for prison escapees.
One thing we NEVER have to "eagerly anticipate" is sanctimony and moral preening from certain bloggers regarding what someone MIGHT say in a combox about an issue that doesn't seem to be as cut and dry as the blogger tries to make it out to be.

As usual, M.Z. offers the more level-headed take:

I don't think a reasonable request is to ask sex offender to castrate himself. While one can construe the chemical castration as voluntary, that would ignore the coercive elements of the act. I think we do a disservice to the quandry when we don't evaluate this.

You run into dangerous territory when you attempt to deem moral or immoral those acts related to an immoral act. A question often arises if it is worse for a boyfriend and girlfriend to have relations with a condom rather than without. Going deeper the question arises whether it is licit for two gay men to use a condom. The first question I would answer in the negative and the second I would answer in the negative, but there are those who would debate those answers, particularly the latter. There are any number of circumstances and qualifiers that would affect people's answers. And before someone mentions it, yes the acts remain objectively evil, but I was addressing subjective culpability. Such will never make an evil act righteous, but is can reduce the actor's culpability.

As to the general case over medical treatments that may cause a reduction in libido or impede procreation, HV makes clear one may do so as long as the intention is treatment of the medical condition and not contraceptive. I'm not aware - meaning that literature could indeed exist and be plentiful, you're reading this in a combox after all - of literature addressing psychotropic drugs that would reduce illicit desires. I'm not aware of literature addressing the liciety of hormone modification to lessen illicit desires.
Now THERE'S a response that actually examines the moral issues involved without devolving into questioning the motives or moral judgment of those who might struggle with the moral and religious implications of a particular act (which don't seem so clearly defined as one might make them out to be).

I also think Blackadder's take is one that makes sense, even if I'm not yet prepared to agree:
Actually, I'd say the difference between chemical castration and physical castration is the difference between anti-psychotic drugs and a lobotomy. Does the fact that one is opposed to lobotomy require one to be opposed to the use of anti-psychotic drugs? I would think not.
If we were talking about physically castrating someone, I'd be the first in line behind Mark in unequivocally condemning that act. But I'm not so secure in the superiority of my own moral reasoning that I can state unequivocally that the use of drugs in treating the sick compulsion of perverts by inhibiting libido (i.e. "chemical castration") is morally illicit.


UPDATE
Now I see that Mark's viewpoint is stated not (necessarily) from sanctimony but from ignorance of what the drugs involved actually do:
Anti-psychotic drugs correct an imbalance that should not be there. Lobotomies destroy healthy tissue that should be there. All legitimate medicine is about helping nature do what it is designed by God to do. Whacking of somebody's balls or zapping them with chemicals so they no longer work is not assisting nature, but thwarting nature [ED.: Apparently, it's "natural" for pervs to have a compulsion to use their equipment to rape little kids?]. I have no problem incarcerating a rapist. But chemically or physically destroying part of his body so that it does not function anymore is, I think, pretty hard to square with the tradition.
(emphasis added)

Blackadder attempts to set Mark straight:
My understanding is that Depo-Provera works not by rendering men impotent, but by reducing the sex drive, along the lines of an appetite suppressant. So describing it as "destroying part of his body" isn't really accurate.
Again, I'm NOT saying that "chemical castration" is morally licit. I've yet to be convinced, and believe it's perhaps not - at the very least, we ought to be putting up some big 'ol "CAUTION" and "DANGER" signs. Indeed, there are certainly moral and religious issues that are raised by this (as M.Z. points out). But I'm just not so cocksure (no pun intended) that it's a slam dunk from the perspective of Catholic teaching.

Besides, I'm all for locking up these pervs for the rest of their lives and throwing away the key (which makes "chemical castration" or whatever you wish to call it irrelevant).


UPDATE #2
An interesting addition to the discussion:
Perhaps its the term castration that is the problem. Perhaps hormone treatment would be less incidiary though might not satisfy everyone.

The National Catholic Bioethics Center has 41 articles on the topic. I can't access them as I am not a member. However, it seems there might be some disagreement on the matter if there are 41 articles.
(emphasis added)

I, too, would be interested in knowing what the National Catholic Bioethics Center articles have to say on this topic, if anyone reading this has access to them.


UPDATE #3
Nevertheless, some are intent on demonizing (literally):
"Hormone treatment" sounds downright diabolical in its euphemism. It's not a "treatment." It's practically a mutilation.
(emphasis added)

To which I answered:
Why? If it's a more accurate description than "chemical castration"?

Perhaps it's "downright diabolical in its euphemism" if your intent is to sanctimoniously demonize or ascribe bad motives and/or poor moral judgment to those who might not be so cocksure (no pun intended) about the moral illicitness of administering these drugs.
Although by using the term "cocksure" a second time, I suppose the pun has, at that point, become intended.

;-)


UPDATE #4
I don't plan to update this post further, so let me conclude by saying that I am not at all comfortable with "chemical castration" or "hormone treatment" or whatever you wish to call it being used as a component of our penal system. I prefer the "lock-em-up-and-throw-away-the-key" model of dealing with sex crimes (especially of the variety involving children).

Nevertheless, I am unprepared to unequivocally condemn the use of these drugs as violating Catholic teaching until I have read something more definitive than a bunch of bloggers and combox mini-popes pontificating on the subject. I'd REALLY like to know what those 41 articles at the National Catholic Bioethics Center have to say.


UPDATE #5 (23 July)
Okay, one more update. But there's a late-breaking development of which you should be aware. Commenter "Phillip" has posted the text of 2 articles from the National Catholic Bioethics Center (the other 39 articles appear not to directly address the matter of chemical castration) beginning here.

While I'm not sure those articles are necessarily dispositive of the issue, they certainly change, in my view, the dynamic of the discussion from one that is "I'm right and all the rest of you on the rubber-hose right who disagree with me are bad Catholics" to one that is more open-ended.

Labels:

19 Comments:

At 7/22/2008 4:08 PM, Anonymous Anonymous said...

Chemical castration no; death penalty for child rapists yes. The punishment for histrionics on a blog site I will leave to others to devise.

 
At 7/22/2008 4:50 PM, Anonymous Anonymous said...

For what its worth, the problem with Blackadder's logic is that it analogizes means rather than ends. Castration is wrong because the end that it achieves: sterilization. The means is not so much at issue.

 
At 7/22/2008 4:58 PM, Blogger Darwin said...

I believe that hanging also results in sterility...

However, since the intent of hanging is not contraceptive, perhaps we could allow it under the principle of double intent.

 
At 7/22/2008 9:05 PM, Anonymous Anonymous said...

Mr. Anderson,

My name is Steve. I ask the following question not intending to challenge you (nor anyone else), but to further my understanding.

If we look at this chemical treatment/castration/whatever you call it as treating a chemical imbalance that should not be there or decreasing the sex drive, it makes me wonder if we're reducing free will to chemical structures.

For example,if giving a child rapist a pill every day could eliminate the danger of him assaulting children, is there room for the soul and for sin and for grace? Or is he just the product of the chemicals that make up his body?

I'd presume that our body chemistry can contribute to our tendencies, but in the end we still have free will. So if our hypothetical child rapist had the chemical tendencies relieved, wouldn't we still expect him to be a threat because his soul is corrupted by sin?

I'm sorry for being unclear. I'm not as versed in Catholic thought as many of you, but if you understand what I'm getting at, I'd love a response.

Thank you!
Steve

 
At 7/22/2008 9:24 PM, Anonymous Anonymous said...

"So if our hypothetical child rapist had the chemical tendencies relieved, wouldn't we still expect him to be a threat because his soul is corrupted by sin?"

I would. I do not believe this crime is motivated by hormones. I think it is motivated by a desire to harm innocent children, and the sick pleasure derived from doing this is not something that chemicals can prevent.

 
At 7/22/2008 9:26 PM, Anonymous Anonymous said...

Mr. McClarey,

Thank you for your answer. One of the areas that causes me to struggle with doubt the most is this biochemistry/neurobiology type of stuff. Sometimes it's hard to see a role for free will and the soul through it. I would appreciate if anybody else has answers as well, however. (Also, I'm sorry if I'm inadvertantly hijacking this post.)

 
At 7/22/2008 9:36 PM, Blogger Pro Ecclesia said...

"Also, I'm sorry if I'm inadvertantly hijacking this post."

Not at all. You raise some very good points. And I agree with Don's answer. That's one of the reasons I'm not so sure the drugs at issue are really something that ought to be a part of our penal system.

My only point in this post is that there are ways of discussing this issue without the person raising the issue automatically assuming bad faith on the part of commenters who haven't even commented yet.

 
At 7/22/2008 9:55 PM, Anonymous Anonymous said...

So, would you say that the suggestion that chemical castration can reform (for lack of a better word) hardened sexual perverts should not be a hindrance to our faith?

Steve

PS: I should mention that your blog is a great service. It's one of the first I check each day, and it does much for the edification of my faith.

 
At 7/22/2008 10:06 PM, Blogger Zach said...

What makes Mark so dang ornery anyway?

 
At 7/22/2008 10:23 PM, Blogger Darwin said...

Steve,

I'm a little unclear from what I've read (and haven't exerted myself to research more) as to whether the "chemical castration" drugs interfere with the males ability to physically achieve an erection, or interfere with his ability to become "aroused" in some more general sense. Either way, though, I don't think it's an interference with free will in that lust and assault are both acts of the will.

I suppose one might say that the drugs would result in reducing the occasion of sin, but they certainly wouldn't prevent one from sinning.

In a sense, the story of medieval theologian Peter Abelard might be relevant. He was physically castrated by the relatives of a student he seduced -- and from what I recall of his writing took that event as an occasion to turn his life around and pursue a more virtuous path. To the extent that he was no longer able to engage in the sin that had got him in trouble, he didn't deserve any particular virtue for not fornicating again. But I seem to recall that he described it taking quite a bit of spiritual work to overcome his lust and related sinful tendencies despite the fact he wasn't able to act on them with much success any more.

 
At 7/22/2008 10:41 PM, Blogger Pro Ecclesia said...

Steve,

I'm not sure I understand your last question. But I honestly don't know enough about the subject to comment definitively on it from a moral perspective. That's why I'd REALLY like to see what the National Catholic Bioethics Center has to say about chemical castration in those 41 articles.

And thanks for the kind words about the blog.

 
At 7/22/2008 10:52 PM, Anonymous Anonymous said...

Just to be clear, I would agree with Shea that the case he mentioned, inmates accepting chemical castration in exchange for early release, is morally wrong. Assuming the prisoner is competent, and he should be competent if he is a prisoner rather than a patient, he should enjoy free agency over his health care. While there may be a case of a parolee being required to maintain a prescribed regimen of anti-depresants or others drugs, to actually initiate such treatment as a condition for release seems manifestly unjust.

In regards to Steve's concerns, drugs are used to treat schizophrenia and other mental illnesses without objection from the Church as far as I'm aware. I can't source it, but an investigation of mental illness is I believe required prior to an exorcism being approved.

 
At 7/22/2008 11:19 PM, Blogger Pro Ecclesia said...

M.Z.,

That's what I thought your take to be (one that agreed with Mark on the moral illicitness of requiring inmates to accept chemical castration in exchange for early release).

The difference is that you actually bothered to examine the moral issues rather than engage in hyperbole and immediately assume bad faith on the part of those who weren't so sure.

 
At 7/23/2008 12:05 PM, Anonymous Anonymous said...

Here's a link to a review of the psychiatric literature on treatments for sexual assault. Behavioral treatments are effective but have a higher rate of recidivism then medical treatments. Their overall recommendation is behavioral treatment with use of medication for those at high-risk for reoffending.

http://psychservices.psychiatryonline.org/cgi/reprint/50/3/349

 
At 7/23/2008 12:56 PM, Anonymous Anonymous said...

Here is the first article:

Chemical Castration: A Cut Above? Or Above the Cut?
How does a new state law relate to an old theological question?
Bismarck once quipped: "The less people know about how laws and sausages are made, the better they'll sleep at night." Sound advice to be kept in mind as we explore this rather contentious topic of chemical castration. Will an old theological controversy be reopened and perhaps even finally settled as society ponders the question of chemical castration?

What will interest us in this article is the recent push in some legislatures, notably California-where else?-to provide chemical castration to prisoners convicted of sexual offenses against children. Before we do so, it may prove helpful to set the stage.

A Definition of Castration

Chemical castration is a new kid on the block. The 1994 edition of Mosby's Medical Dictionary defines castration without any reference to chemicals:

The surgical excision of one or both testicles or ovaries, performed most frequently to reduce the production and secretion of certain hormones that may stimulate the proliferation of malignant cells in women with breast cancer or in men with cancer of the prostate. The patient must be informed that bilateral excision of the gonads causes sterility.
We note that castration is a variation of sterilization.

Legitimate Medical Uses

Much of the medical literature on the subject of chemical castration chronicles experiments done on mice and rats. While there are journal articles that deal with human subjects, the vast majority of these treat chemical castration in the context of prostate cancer in men, breast cancer in women. Depending on the medical facts of a given case, chemical castration, a form of hormone deprivation treatment, can buy time for prostate cancer victims by slowing the growth of the disease by lowering, at least for a while, the prostate specific antigens [PSAs] that indicate the extent of the cancer.

Monsters among Us

In February 1997, Lawrence Singleton, was arrested in Florida for stabbing a prostitute to death. The news reports tell us that this is the same man who years earlier kidnapped a young girl in California, raped her, and then hacked off her forearms before leaving her by the side of the road. Convicted of the California crime, Singleton did his time and was released, surfacing in Florida this time not only to rape but also to kill. Seven-year old Megan Kanka, after whom "Megan's Law" is named, is molested and murdered in New Jersey by a two-time sex offender. John Wayne Gacy, that charismatic clown, murdered 33 young men between 1972 and 1978 and buried them under his house. And Jeffrey Dahmer, well...

Such atrocities are not peculiar to America. In Scotland, Thomas Hamilton walks into an elementary School in Dunblane on March 13, 1996 and slays 16 school children along with their teacher. Belgium is still reeling from revelations of a convicted child molester, Marc Dutroux, who may have been involved in an international pedophile sex ring. Two 8-year-old girls, Julie Lejeune and Melissa Russo, starved to death after spending nine months in one of his dungeons. And in Russia we find the granddaddy of all sexual serial killers, Andrei Romanovich Chikatilo, killer and mutilator of at least 52 victims in a 12-year orgy of death before he was finally apprehended and put to death in February of 1994.

Incredibly, most of these miscreants were known to authorities, had criminal records, and some had been imprisoned for a while, 'paying their debt to society,' before being released where they picked up where they had left off. Has a civilized society any defense against such malefactors?

The California Chemical Castration Law

Since California is the most populous state and has the largest prison population of child molesters, perhaps it is only to be expected that-in response to atrocities similar to those described above-Governor Pete Wilson signed into law a measure approved overwhelmingly by that state's legislators. Slated to take effect on January 1, 1997, the California law requires chemical castration of repeat child molesters as a condition of their parole. Judges have the discretion of applying the law to first-time offenders convicted of a particularly heinous crime. Offenders may choose surgical castration if they so wish. Unlike its surgical counterpart, chemical castration has the advantage of reversibility; once the treatments stop, the sex drive is said to return.

The Theory Behind the Treatment

Treatment consists in twice-a-week injections of the drug, Depo-Provera. When administered to women, the drug acts as a contraceptive; when given to men, Depo-Provera acts on the brain to inhibit the hormones that stimulate the testicles to produce testosterone. The thought is that decreased testosterone levels should lead to a lowered sex drive.

The drafters of the California law often cited European studies to back up their contention that the repeat rate for child molesters dropped dramatically when chemical castration was applied. Assemblyman Bill Hoge, the bill's sponsor, used the figure of 2% as the recidivist rate found in one study. Governor Wilson said the law would be worthwhile even if only one child was spared the ordeal of sexual predation and molestation.

While praised by some as a model piece of legislation, others were not slow to criticize the California law. "Cruel and unusual punishment" to some, a "reversion to the Dark Ages" to others. The ACLU promised a challenge on constitutional grounds. The California Psychiatric Association deemed the bill clinically inappropriate. More than one physician chastised the Golden State lawmakers for meddling with medicine.

The Morality of Chemical Castration

We leave the realm of California state law and enter the world of ethical reflection. What of the morality of chemical castration as a deterrent to the sexual molestation of children? As already noted, castration is a form of sterilization. Moralists classify sterilization as either direct or indirect. Health care professionals, on the other hand, speak of sterilization most often as either contraceptive or therapeutic. The 1978 edition of The Encyclopedia of Bioethics lists five types of sterilization: (i) therapeutic, (ii) contraceptive, (iii) eugenic, (iv) social, and (v) punitive.

Church Teaching on Punitive Sterilization

The pages of Ethics & Medics have often treated Catholic teaching on the morality of therapeutic sterilization and the immorality of direct sterilization. What does the Church teach about other types of sterilization? In Casti Connubii, his 1930 encyclical on Christian Marriage, Pope Pius XI is quite clear regarding the immorality of eugenic sterilization:


Public magistrates have no direct power over the bodies of their subjects; therefore, where no crime has taken place and where there is no cause present for grave punishment, they can never directly harm, or tamper with the integrity of the body, either for the reasons of eugenics of for any other reason.
When some moralists concluded that Casti was declaring not only eugenic but also punitive sterilization unlawful, fascicle 14 of the Acta Apostolicae Sedis for 1930 emended the text enough to make it clear that the morality of punitive sterilization was still not determined. That is exactly where the matter remains, almost 70 years later.

A Question Still Open

According to Redemptorist Francisco Basterra: "As for penal sterilization, it does not appear to be excluded by any of the Church's teaching" [Bioethics (1991), p. 113]. Basterra goes on to note that while it may well be true that no church teaching excludes punitive sterilization and that there were theologians in the past who approved of the procedure, it is also true to say that the very notion of punitive sterilization had fallen into disfavor in recent times.

It is at this precise point that the chemical nature of the new ways of applying this particular remedy may well come into play. Punitive sterilization in the old days was nothing if not draconian-castration, with its definite finality. The newer way of applying this punishment is in theory, at least, temporary, not permanent.

Expanding on what the Catechism [#2266] says of society's right to protect itself, Pope John Paul II notes:


[T]here is evidence of a growing public opposition to the death penalty, even when such a penalty is seen as a kind of "legitimate defense" on the part of society. Modern society in fact has the means of effectively suppressing crime by rendering criminals harmless without definitively denying them the chance to reform [Evangelium vitae, 27].
Could chemical castration fit under this rubric?

Conclusion

May society attempt to protect its children by means of chemical castration of repeat sex offenders? The thought of stopping the John Wayne Gacys and the Jeffrey Dahmers is appealing, yet a major practical consideration will be: How effective is such treatment? We ought not look upon chemical castration as a panacea; it might help some, yes, but it could well enrage others, a point noted by many critical of the California bill, including Dr. Fred Berlin, founder of the Sexual Disorders Clinic at Johns Hopkins.

Before embarking on such a course of action, society ought to make provisions that the drugs be administered in conjunction with proper counseling and medical follow-up since there can be quite severe side-effects of female hormones on males. Such provisions were lacking in the California legislation signed by Governor Wilson and may well short-circuit the bill's effectiveness. The human being is more than a mere congeries of chemicals. The California law, good intentions notwithstanding, suffers from a sort of terminal materialism in its overly simplistic approach. If coupled with counseling and medical monitoring, chemical castration may be able to achieve not only punitive but corrective and preventive ends as well.

Fr. Germain Kopaczynski, OFM Conv.
Director of Education

 
At 7/23/2008 1:03 PM, Blogger Pro Ecclesia said...

JohnA,
Thanks for the link.


Philip,
Thank you for posting the text of that article.

I note with interest that there is no indication from Fr. Kopaczynski that he believes "hand amputations are suitable for thieves, tongue branding or removal is justice for slanderers, and foot removal is the due penalty for prison escapees".

 
At 7/23/2008 1:08 PM, Anonymous Anonymous said...

There only seems to be one other article there directly address this. (the other 39 seem to address hormonal therapy for other situations. Why a search pulled these up also is beyond me.) Anyway this one addresses pedophilia. Under treatment of said is this quote:
"Treatment of pedophilia takes many forms. In Northern Europe, castration has been found to be a very effective treatment for hypersexuality, with a recidivism rate of only 2.2%. This is illegal in the United States and would not directly address the pathology of pedophilia anyway since the problem of pedophilia is not sexual drive but misdirected emotions such as love and tenderness which are not eliminated by castration.

In the United States, while there is no completely uniform method of treatment, it is generally agreed that initial therapy not be a once-a-week sort of support group like Alcoholics Anonymous. Rather, a residential, multi-modal form of therapy is indicated. The treatment modalities include individual therapy, group therapy, alcohol monitoring (since there is a high instance of chemical or substance abuse among sexual offenders), medication, and self-help groups.

Medication could include anti-depressants or antianxiety agents. Hormone or drug therapy, such as Depo-Provera, have been used to reduce the testosterone level of the patient. While this is an anti-libinal drug and potentially effective for treating this illness, its use needs to be carefully evaluated because long term effects of suppressing testosterone and associated adverse effects to sperm is not well known."

There seems to be an assumption here that such treatment is licit if properly done.

 
At 7/23/2008 1:19 PM, Blogger Pro Ecclesia said...

Philip,

Once again, thank you. While I'm not sure those articles are necessarily dispositive of the issue, they certainly change, in my view, the dynamic of the discussion from one that is "I'm right and all the rest of you on the rubber-hose right who disagree with me are bad Catholics" to one that is more open-ended.

 
At 7/23/2008 1:45 PM, Anonymous Anonymous said...

There is a very simple biblical response to rape: 'his blood is on his own head.' But recently Catholics in general have become categorically confused about the justice of execution, in their race to make 'life' itself somehow sacred. But death has entered the world, and particularly in the context of eternity, the death of an individual is far from the worst thing that can happen to him. Just check with the martyrs.
Similarly, if the execution of judgment on rapists - in the form of making real the 'blood' that is already on their own hands - can cause some number of them to repent in a timely fashion and avoid eternal death, then as a society a great good has been done, both for those repenting individuals, and in bringing about a more perfect justice on the earth.

However, without the inherent good of capital punishment in the case of rape, we are left with the imperfect - measures meant to prevent repetition without repentance, for example, like permanent imprisonment. In these cases, is it better to imprison a person's whole body, or to restrict their movements or actions in a more particular form? One might suppose that keeping a pedophile away from temptation and keeping kids out of harms way would allow a person to otherwise pursue goodness, and help them avoid evil. In the same vein, chemical castration, probation requiring a thief to have a regular job and tracking his movements, etc, would promote the well-being of a person who has clearly succumbed to temptation in the past.
If we choose a more restrictive means, we must be doing it because we believe there is a good in punishment, because we are trying to inflict a degree of suffering.

 

Post a Comment

<< Home

hit counter for blogger