Controversies in treatment: Should a sexual offender be allowed castration?

Alexander, Mary Jane; Gunn, John; Cook, David Angus Graham; Taylor, Pamela J.; Finch, John R.

doi:10.1136/bmj.307.6907.790

Cited by 22 publications

(9 citation statements)

References 8 publications

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“…The treatment of these candi dates should be openly debated to weigh ethical issues on an individual basis, as for example in the case of a sexual offender who demanded surgical castration after it had been aban doned in Europe. 23 The motivation for DBS treatment should not be connected to any hopes/promises of prematurely leav ing prison or a forensic treatment facility as in the 1970s when most of the imprisoned sexual offenders were released after the operation. The boundary between treatment and punish ment must be very clear.…”

mentioning

confidence: 99%

Deep brain stimulation to reduce sexual drive

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Auer

Biedermann

et al. 2015

J Psychiatry Neurosci

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To date there are few treatment options to reduce high sexual drive or sexual urges in paraphilic patients with a risk for sexual offending. Pharmacological therapy aims to reduce sexual drive by lowering testosterone at the cost of severe side effects. We hypothesize that high sexual drive could also be reduced with deep brain stimulation (DBS) of circuits that generate sexual drive. This approach would help to avoid systemic side effects of antiandrogenic drug therapies. So far the best investigated target to reduce sexual drive is the ventromedial hypothalamus, which was lesioned unilaterally and bilaterally by stereotaxic interventions in paraphilic patients in the 1970s. Here, we discuss DBS as a treatment strategy in patients with severe paraphilic disorders with a serious risk of sexual offending. There are profound ethical and practical issues associated with DBS treatment of paraphilic patients that must be solved before considering such a treatment approach

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confidence: 99%

Deep brain stimulation to reduce sexual drive

Fuß

Auer

Biedermann

et al. 2015

J Psychiatry Neurosci

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“…Although it has yet to receive adequate study, early experience with surgical castration of sex offenders suggests that this continued hormone production is clinically meaningful, since sexual impulses, erections, and performance ability may persist in up to 25% of those who have been forced to undergo the procedure (21). If given equal weight, these principles commonly come into conflict.…”

Section: Ethical Issues In the Physician-patient Relationshipmentioning

confidence: 99%

Psychiatric Evaluation of a “Monk” Requesting Castration: A Patient's Fable, With Morals

Roberts¹,

Hollifield²,

McCarty³

1998

AJP

156

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“…EDITOR, - Aileen Clarke and colleages suggest that female castration should receive the same attention as surgical castration for sexual offenders 1, 2. I have two comments.…”

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confidence: 99%

“…Secondly, the statement that oophorectomy is a “controversial method of reducing the risk of ovarian cancer”2 needs to be explained further or it may leave readers confused. Rare cases of primary peritioneal carcinoma (which in all respects resemble ovarian carcinoma) have arisen in women who have had bilateral prophylactic oophorectomy because of a strong family history of ovarian carcinoma 3.…”

mentioning

confidence: 99%