Chemical castration: How a medical therapy became punishment and the bioethical imperative to return to a rehabilitative model for sex offenders.

摘要

Chemical castration is a colloquial term used to refer to the treatment of certain sex offenders with antiandrogenic drugs in order to reduce recidivism. The use of this treatment began in the United States in 1966, at which time the nation favored a rehabilitative approach to criminal justice. In its first thirty years of use, chemical castration proved effective at reducing recidivism rates among one subset of offenders, paraphiliacs, by about fifty percent.;In the late twentieth century, a shift in public opinion led to a prioritization of retributive justice over the existing rehabilitative model. This push toward retribution led to the drafting and subsequent passage of nine state statutes mandating castration therapy for offenders who commit certain crimes. Seven of these statutes remain in effect as of late 2012. These laws incorporated an effective therapy within a model of retributive punishment, a move that continues to raise serious bioethical questions today.;This thesis examines chemical castration within both a therapeutic and punitive context. I discuss the side effects and legal implications of castration as it is currently used, as well as the bioethical issue of how one ought to respect patient rights when treatment is administered as punishment. The bioethical principles of respect for autonomy, beneficence, nonmaleficence, and justice are discussed, as are the appropriateness of a risk reduction argument for castration and several logistic issues related to this treatment. I ultimately argue against the retributive use of chemical castration and propose a return to a rehabilitative approach to this intervention.