- Published: October 31, 2012
In his law review titled “Florida’s 1997 Chemical Castration Law: A Return to the Dark Ages,” L. H. Spalding of the ACLU discusses the use of medroxyprogesterone acetate (MPA), a drug used to reduce testosterone production in sex offenders. While California was the first state to enact legislation in 1996 that mandated MPA injections for convicted sex offenders as part of their probation regulations, Florida followed suite in 1997 with its Chemical Castration Statute: “[A] trial judge [is authorized] to sentence any defendant who is convicted of sexual battery to receive MPA. If the defendant is convicted of sexual battery and has a prior conviction for sexual battery, the trial court is required to impose a sentence of MPA administration” (Spalding 120).
The trial judge must have a medical consult who determines that the “defendant is an appropriate candidate for treatment,” (Spalding 123), but as Spalding points out, the language is vague. Because terms like “medical expert” and “appropriate candidate” are undefined, this haziness leaves a lot of room for abuse. One of the most harrowing aspects of the castration statute is that there is no requirement to inform the defendant of the medical risks of MPA use. Because informed consent is not mandated, defendants are at risk for numerous MPA side effects, a laundry list which includes:
“increased appetite, weight gain of fifteen to twenty pounds, fatigue, mental depression, hyperglycemia, impotence, abnormal sperm, lowered ejaculatory volume, insomnia, nightmares, dyspnea (difficulty in breathing), hot and cold flashes, loss of body hair, nausea, leg cramps, irregular gall bladder function, diverticulitis, aggravation of migraine, hypogonadism, elevation of the blood pressure, hypertension, phlebitis, diabetic sequelae, thrombosis (leading to heart attack), and shrinkage of the prostate and seminal vessels" (Spalding 125).
This failure to obtain informed consent and the possibility of horrific results brings to mind a One Flew Over the Cuckoo’s Nest dystopia, where the government uses drugs to control the people. Additionally, the severity of the side effects suggests that MPA is being used as a form of punishment rather than as a form of treatment.
In addition to the lack of informed consent, the strict use of MPA to treat all types of sex offenders blatantly ignores underlying causes for criminal behavior, such as violence. By ignoring different categories of sex offenders, the criminal justice system instead views the drug as a panacea. I believe it is irresponsible to administer a drug without any kind of corresponding psychotherapy or therapeutic counseling. While the “U.S. Supreme Court has recognized that an individual possesses a liberty interest that includes the right to withhold consent to intrusive medical treatment” (Spalding 127), there is a tension between balancing the safety of the individual with the safety of the prison or the larger society. For instance, mandatory strip searches prior to incarceration may be considered a violation of privacy, but they are deemed necessary to prevent the spread of disease and illegal contraband among prisoners. However, I don’t think one could make a valid case that removal of all reproductive autonomy is necessary for the greater good of society. The long-term effects of MPA are still unknown, and its use for chemical castrations has not been approved the FDA. The current way that MPA is mandated has too many drawbacks for this to be an ethical or effective rehabilitation option. Unless large changes are made—namely, mandating informed consent and giving the defendant an actual choice to refuse treatment— further use of MPA and chemical castration should be banned.
L.H. Spalding. (1998). “Florida’s 1997 Chemical Castration Law: A Return to the Dark Ages.” Florida State Law Review. 25: 117-139.