Medicine and Capital Punishment - Essay Example

Philosophy Topic: Biomedical ethics The medical profession is a science not only regulated by policies but also of moral imperatives in healthcare management. As agents to sustain life within medical facilities and as agents of court-regulated mandates over punitive measures, medical practitioners remained ascribed with rules that limit their actions and interventions with patients. In this paper, researcher is challenged to explore the correlation of medical profession with ethical concerns viz-a-viz issues relating to chemical castration to capital punishment. While the American Medical Association (AMA) has strong opinion about the ethical challenges on chemical castration, but its proprietary and coherence remained subject of debate amongst pro and anti-chemical castration. The advocates of the latter contend that it is a violation of the Eighth Amendment which protects the dignity of men. Using analytical and philosophical discourse, this study will tackle the ethical dilemma associated with chemical castration as a punitive and treatment for those criminally adjudged child molesters or rapist. Context of the Issue The increasing recidivism of sexual offenders prompted authorities to introduce an approach to enforce programs of chemical castration, a medical treatment that induce the reduction of prurient interests or sexual deviancy amongst rapists or child molesters. The medical application includes Norplant implant, administering cypoterone, diethystilbestrol, an anti-androgen, medroxyprogesterone acetate or the Depo-Provera injectable birth control among others, but when injected to males, can reduce sex-drives (Meisenkothen, 1999). Medical experts posit that chemical castration refers to medication aimed at reducing sexual appetite. This is introduced to persons convicted of rape or of child molestation. Experts professed that chemical castration is reversible when treatment is stopped, albeit facts that the intervention has physical effects to whom it is introduced (Rondeaux, 2006).This is different to surgical castration because it does not include incision and removal of testes (Rondeaux, 2006; Bradford, 1993; de Sweemer-Ba, 1993). It’s simply the injection of medicines to lower testosterone and reduce sex drives. As a consequence of this penal policy, convicts can only be freed from confinements after acquiescing to this procedure; otherwise theyd remain in prison. It’s even viewed as an alternative to penalties that will cover reclusion perpetua to death penalty (Rondeaux, 2006; Bradford, 1993; de Sweemer-Ba, 1993). This is now adopted as a matter of policy in penology in the nine states in United States although the penalty of chemical castration is more evident in Iowa, California and Florida. This is adopted in Louisiana as a policy signed into law in Senate Bill 144 and became part of their criminal law’s penalty for rapists. In Europe, chemical castration evolved as part of suppressing homosexuality then perceived as psychiatric illness, although others opted to avail of it as an alternate of imprisonment (Rondeaux, 2006; Bradford, 1993; de Sweemer-Ba, 1993).It was only in 2008 when authorities in Europe used chemical castration under an experimental program and as significant rehabilitation procedure. In a case in UK, however, consent is generated before chemical castration became a part of his penalty in conviction. Consent from a felon was also taken before the court enforced chemical castration to a convict in Israel in 2009 but not in Australia over recidivist in one of its case in 2010 (Baczynska, 2009; BBC, 2010a; BBC 2010b; Baczynska, 2009). In Argentina, chemical castration was first approve into law before its enforced as a penalty and consent was also derived to ascertain voluntary acquiescence (Baczynska, 2009; BBC, 2010a; BBC 2010b; Fontana, 2010). On a positive note, Argentina considered chemical castration as a therapy and those who indulge into this medication will have its offenses offset at a certain period (Libman, 2009). In Asian countries, South Korea was first to legislate a policy allowing the court to impose chemical castration to child molesters whose victims aged 14 and below, although the punitive measure pass through a process of enforcing the penalty through a forensic psychiatrist (Sung-Won, 2011). Implications to Bioethics Chemical castration is considered as part of the advancement of biology and medicine to meet the needs or cure of human ailment and behaviors. Sexual pedophilia and the increasing number of cases relating to rape, molestation and sexual harassments have challenged and motivated medical and pharmacological experts to develop medicines that could address issues on sexual disorders (AMA, 1996; AMA; 1995). In this late part of the 21st millennium, pharmacologists introduced varied medicines, in tablet or injectable, to temper sexual libido and deviancy. The medicines, as explained earlier, is now being applied to convicts as a matter of penal policy or as medical intervention to address problems of rapists to change the behavior of those convicted with rape and child molestation-- recidivists or not (AMA, 1996; AMA; 1995). The practice is adopted in some states in America, in Europe and in other countries, although they vary in their methods and intents of applications. The American Psychiatric Association (1981) defined sexual deviation disorders or paraphilias as a diagnosable psychiatric syndromes manifested by intermittent fantasies about unusual sex; severe associated hankering; and, stereotypic behavioral reactions. This is reflected among pedophiles who’d opt children as their object of prurient interests and erotic urges. AMA (1981) further explained that paraphiliac syndromes usually trailed a chronic course and possibly connected to biological pathology, however its etiological factors are not quite understood. Under the utilitarian principles, treatment is a necessity when these psychiatric ailments affect and compromise the well-being and rights of others. Utilitarianism is a moral imperative which opts to prefer actions that could provide the greatest good consequences for everyone. Medical experts proposed that these undesirable and offensive sexual deviancies can be treated through psychotherapy, surgical castration, and behavior therapy-- the latter is currently known as chemical castration. The introduction of medroxyprogesterone acetate among other related medicines assisted in the reduction of testosterone level and could diminish sexual preoccupation and urges, making self-control easier (AMA, 1981). Despite criticism of alleged ineffectively in reducing sexual deviancy, medical experts pressed based on scientific observation using 48 male patients with evident deviant sexual behavior who were administered with medroxyprogesterone acetate as therapy for 12 months. Their findings showed that within three weeks, the object of studies has reduced its frequency of sexual imaginations and arousal, mitigated their deviant sexual behavior, got better control over sexual urges, and they illustrate more rational psychosocial functions (AMA, 1981). Psychiatrists however asserted that medicating deviant sexual behavior and achieving sound minds can be only be sustained with treatment coupled with counseling programs to educate and provide them better decisions in strategically addressing their sexual behaviors (AMA, 1981). It’s on these foregoing empirical facts where legislators and adjudicators perceived the necessity to employ chemical castration to sexual deviancy and to temper the behaviors of those offenders set on parole to ascertain that they will not exert the same offense to innocent victims, especially children. Medical Experts: Questions & Doubts It’s however clear that chemical castration is administered, not to every male in a populace, but only to convicts who needed such treatment as part of the punitive measures and upon the determination of court. Such administration is done with the appointment of a medical expert who will perform the medical interventions. However, it’s in this stage when significant medical, legal, and ethical issues are raised by those opposed to chemical castration (Francis, 2011; Gordon, 1997). Primordial of their concerns are demands that adjudication of the court on cases relating to rape and child molestation cases should probe and prove the guilt of accused beyond reasonable doubt to avoid affliction of injustice on him. Such will also address concern if the person is a legitimate candidate for the treatment. While medical examinations are presented to court, the same should be subject to re-investigation and rebuttal of experts to truly afford the accused of procedural protection in the legal process, which is fundamentally imbibed in the Miranda doctrine (Johnson. 2010; Vanderzyl, 1994; Russell, 1997; Miller, 1997; Fromson, 1994). Such is inclusive of the right of the sexual psychopath to be also heard and be represented by his lawyer in the determination of evidences hurled against him. Evidences should be exacted to gather formidable proofs and verified facts to remove any room for doubt and vagueness; hence, testimonies in this criminal prosecution should be clearer than the sun and as accurate as mathematical formulas (Vanderzyl, 1994; Russell, 1997; Miller, 1997; Fromson, 1994; Gordon, 1997). A number of those who doubted this medical punitive process likewise ask if free, prior and informed consent is generated from the offender and his family. They ought to be fully informed about the impacts, medical risks and extensive results out of these treatments. The latter is inclusive of the court’s goal in bestowing this kind of punitive measure. Such must also disclose with clarity about the compatibility and required absorptive capacity or the tolerance level of person to the kind of medication he is going to underwent within prescribed period (Munthe, Radovic, & Anckarsater, 2010). This is because some experts oppose to chemical castration argued that while medicines used are effective in suppressing erection and in reducing the intensity of eroticism, they are likewise anxious to the side effects of this treatment (Melella, 1989 & Bradford, 1983; Peters, 1993, Vanderzyl, 1994). Some physician pointed that among the side effects observed in chemical castration are enhanced appetite, increase of weight, easy exhaustion, psychological melancholy, hyperglycemia, impotence, decrease of ejaculatory volume, sleeplessness, dyspnea, uneven body temperature, body hair loss, hair, nausea, physical cramps, malfunctioning of gall bladder function, diverticulitis, migraine, hypogonadism, hypertension, phlebitis, diabetic sequelae, thrombosis, frustration of prostate and seminal vessels (Melella, 1989 & Bradford, 1983; Peters, 1993, Vanderzyl, 1994). On the other hand, it is however medically essential that these implications be reviewed by medical experts and to ascertain if these implications are directly associative to chemical castration or independent to it, in the interest of offender’s right to health (Meyer, 1992; Crimson, 1993). AMA (1981) explained that following their oaths, physicians should ethically participate in court-initiated medical treatments only when the mandate accorded by the judiciary to psychiatrists or physician is therapeutically effective and not solely a mechanism of social control against sexual deviancy. This is because while the judicial body possessed authority to determine criminal guilt, the court is unclad of such capability to undertake medical diagnosis as well as the necessary pharmacological intervention to heal sexual deviancy. Ethically, medical practitioners are mandated to medicate patients based on empirical medical diagnoses and not based on court rules and procedures. AMA (1981) pointed that this is significant especially for in-patient therapy, surgical operations, or pharmacological treatment, e.g. sexual deviants. In the latter case, while diagnosis and treatment are done by physicians, the same must necessarily be confirmed by independent physician or panel of medical experts to validate initial findings on tackled issue e.g. sexual deviancy (AMA, 1981). However, matters relating to court-ordered counseling or referrals for psychiatric evaluations need not undertake second opinions because these are simply prescriptive and does not require drug’s administration (AMA, 1981). It is likewise proposed that an organized independent body should establish standard scientifically valid treatments for medically determined diagnoses for case-to-case basis, depending on the convicts’ behavioral level on sexual deviancy. AMA (1981) believes that its proper that medical experts should conclude, with good conscience and proficient professional judgment, that medical intervention do not vitiate voluntary informed consent noting for a fact that judicial decisions has evident element of coercion in the enforcement of punitive actions. In in-patient therapy and pharmacological treatment done in chemical castration, an independent physician or a panel of physicians must confirm that the informed consent was exacted from patient based on their professional guidelines (AMA, 1981; AMA, 1995; Stinneford, 2006). Legal Implications While it’s argued that medical intervention is necessary to temper sexual deviancy, there remained substantial legal questions about prisoners constitutional human rights. This is because while it’s correct that offenders have limited rights and have diminished their liberty as a consequence of their convictions, but such did not totally stripped them of their fundamental rights and protection. Constitutionalist argued that there should be no involuntary treatment and absence of consent from the offenders and their respective families. But aside from non-consequentialist’s perspective, the Supreme Court uphold key questions to determine if chemical castration, as medication and punitive measure is inherently cruel within the meaning of the Eighth Amendment: (1) is chemical castration violative of the dignity of man which is fundamental to the Eighth Amendment?; (2) Is chemical castration violative of the standards of decency? (3) is chemical castration a wanton infliction of pain and hence, hinder or ineffective in retribution, deterrence, and in rehabilitative goals of the convicted patient?; and (4) does chemical castration instigate torture or is it a barbaric punitive measure? (AMA,. 1981; AMA, 1996; AMA, 1995). On the other hand, following philosophic note, the question also raised whose rights are suppose to be defensible in the court of law and in the eyes of moral imperatives, the raped or the rapist? Molested or the molesters? Such provide complex web of rights and obligations since the concept of human dignity is a general or broad term and is applicable to both innocents and convicts (AMA,. 1981; AMA, 1996; AMA, 1995). Some legal luminaries contend that there is no clear guidance yet about how some moral principles should be harmonized with criminal penalties following the challenges inherent in the letters and intents of the Eighth Amendment viz-a-viz chemical castration laws. On the other fence, such similarly precipitated questions which challenged those opposed to chemical castration: when is a barbarous punishment be considered unacceptable? Is it barbaric and unacceptable if chemical castration address penological goal? Those oppose to chemical castration pointed that it’s cruel punitive act because it’s making the person incapable of experiencing sexual desire, thus violative of the Eight Amendments (AMA,. 1981; AMA, 1996; AMA, 1995). Two of its major contentions is that (a) a number of those penalized with chemical castration are actually bereft of sexual disorder and, (b) its an assault to the physical well-being of the person specially that the administration of drugs has its alleged inherent side effects that are perceived fatal and disabling impacts to the offender (Melella, 1989 & Bradford, 1983; Peters, 1993, Vanderzyl, 1994).. Conclusion Chemical castration, as treatment and punitive measure, is a controversial matter. But at the height of debates, there are realities that ought to be recognized as premises to arrive at better conclusion of these ethical questions. First, laws are made to uphold social orders, peace and human dignity. Second, it’s the role of the judiciary to enforce laws and punitive actions to those adjudged criminals to accord distributive, retributive and rehabilitative components of the justice system. Hence, the court must exercise its obligations proficiently and effectively in the dispensation of justice. Third, there is nothing wrong about sex, provided it’s done by free consenting adults; in observance to some cultural norms; it’s completed with love and for pleasure; and such pleasure is generated without violating the rights of the object of sexual desire. In that context, there are more realities to accede to in addition to the enumerated. The fourth reality is that rape and child molestation is a criminal offense that violates the human dignity of the victims and the laws. Fifth, some cultures viewed child rape and molestation as not only a criminal offense; but also as barbaric attack to moral standards, and an injustice to a child whose victimization will make her bear a lifetime of psychological distress. Sixth, it’s difficult to view sexual deviancy, pedophilia and molestation as a normative sexual option of some adults whose sexual drives are beyond the socially acceptable acts. There is no culture so far which advocates the rape of children. Seventh, there are persons who perceived that pedophilia is not a psychological disorder and there reasons need to be restudied too. In a more profound level, the seventh reality is that the judiciary is tasked to penalize persons adjudged guilty of a crime in order to reform and rehabilitate him before he will be freed again and be mainstreamed back to the society after the completion of his sentence. Part of the rehabilitation process is the introduction of chemical castration to those convicted of rape and child molestation to reduce their sexual deviancy and to decrease the number of victims in the society. Such process is accompanied with psychiatric session to educate and debrief him from his offence and from his sexual behaviors. However, this necessitates enforcement of medical mechanism and ethical considerations. AMA was right to propose that while the accused be accorded with his legal rights and representations in courts to hear his side, it’s likewise imperative for medical practitioners to create an independent body that would examine and determine one’s level of sexual deviancy with the concurrence of the court and based on evidences accumulated relating thereto. The provision of medical assistance is not intended to barbarically manage him as prisoner, rather as part of the rehabilitation process to temper his sexual urges for his well-being and for the society. In so doing, medial examination must involve the determination of the absorptive capacity of the person who’d voluntarily accede to chemical castration. Further, it must be recognized that there is no government in this world who can tolerate to see children and women as helpless victims of rape and molestation. Similarly, the government cannot tolerate to have constituents who practice unjust fornication to either adult women or to innocent children— which is clearly offensive to moral standards and to the law of men. A just society requires all stakeholders to be part of a society that upholds human dignity and values. Added to this is the necessary to affirm that the introduction of chemical castration should not vitiate the consent of the offender and of his family to ensure that they are accorded with right information and just legal process. The same must likewise be instituted by medical experts only, solely on the bases of verified facts of one’s sexual deviancy, upon a court order and in consonance to the ethical standards associated to medical profession. In the end, the interest of the society is to holistically make this a place worthy of living and to see that justice genuinely works for everyone at all fronts. References American Psychiatric Association. 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