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Endocrine Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Degarelix is presently the best-known example of a GnRH antagonist used in the treatment of prostate cancer. It was developed, and is now marketed by, Ferring Pharmaceuticals under the trade name FirmagonTM. It contains ten amino acid residues as in GnRH itself, but many of these are chemically modified (Figure 8.30). It was approved by the FDA in 2008 for the treatment of patients with advanced prostate cancer, and was subsequently approved by the EMA in 2009. In the UK, it is recommended by NICE for the treatment of advanced hormone-dependent prostate cancer. It has also been studied for use as a chemical castration agent for sex offenders in Sweden.
Disordered and offensive sexual behaviour
Published in John C. Gunn, Pamela J. Taylor, Forensic Psychiatry, 2014
Don Grubin, Jackie Craissati, Harvey Gordon, Don Grubin, John Gunn, David Middleton, Don Grubin, Gisli Gudjonsson, John Gunn, Donald J West
When medication is used in the treatment of sex offenders it is frequently referred to as ‘chemical castration’. This fails to distinguish between the different types of drugs that are prescribed, not all of which act directly through testosterone. Unlike castration, even with anti-libidinals medication dose can be titrated and stopped if necessary; side-effects are more easily managed. Because the negative connotations of the term ‘chemical castration’ in itself may deter offenders from considering a potentially effective treatment, the term ‘castration’ should probably be kept in reserve for the surgical procedure.
Infanticide, Filicide, and Other Abuses
Published in Lita Linzer Schwartz, Natalie K. Isser, Endangered Children, 2011
Lita Linzer Schwartz, Natalie K. Isser
Child molesters or pedophiles are another group to be considered. Usually male, from teenagers to those in mid-life, their victims are usually girls who are relatives or neighbors (Murray, 2000). Their offense may range from fondling to rape. Sex offenders are supposed to register with local police under Megan’s Law of 1994, and to live at a distance from schools and playgrounds, but juvenile sex offenders are protected from doing so under other laws (Jones, 2007). They may, however, be found on the Internet, with the result that they are then often threatened or assaulted by classmates or others. Chemical castration may be ordered by a court (Swerts, 2005) even if the young offender is not imprisoned. Too often, he does not have access to rehabilitation therapy or support from family members, which makes recovery more difficult.
The pharmacologic treatment of problematic sexual interests, paraphilic disorders, and sexual preoccupation in adult men who have committed a sexual offence
Published in International Review of Psychiatry, 2019
Belinda Winder, J. Paul Fedoroff, Don Grubin, Kateřina Klapilová, Maxim Kamenskov, Douglas Tucker, Irina A. Basinskaya, Georgy E. Vvedensky
While the use of testosterone-lowering medications is sometimes referred to as ‘chemical castration’, this term is inappropriate, since the effects are temporary and vary according to type of medicine and dosage used. Surgical castration (bilateral orchiectomy) is an irreversible procedure involving the removal of the testes or testicular parenchyma, leading to a reduction in the level of circulating sex hormones, and subsequent diminution of libido (Zvěřina, Hampl, Sulocava, & Starka, 1990). The practice of surgical castration raises important ethical and legal questions (e.g. Stojanovski 2011; van der Meer, 2014). For example, opponents of surgical castration question the extent to which people can voluntarily submit to this irreversible procedure (Heim & Hursch, 1979). Advocates emphasize the proven efficacy of the procedure, the fact that it is a logical voluntary treatment choice for many patients and their caregivers, and that it provides patients with better behavioural control and the possibility of greater independence from the healthcare system, since there is no need for continued pharmacologic treatment to lower testosterone (Krueger, Wechsler, & Kaplan, 2009).
Punishing Intentions and Neurointerventions
Published in AJOB Neuroscience, 2018
Nonetheless, this idealization can only get us so far. It does not provide practical guidance for the permissibility of neurointerventions in any scenario we will face for the foreseeable future. This is because neurointerventions will not merely affect the likelihood of offending, but also they will affect other aspects of the offender’s life, and these can be significant harms. This is apparent in our current practices of chemical castration. Besides the diminution of sexual desire, chemical castration has side effects such as increased body fat and an increase in male breast tissue. It also has significant effects on the offender’s mental states; for example, it interferes with the offender’s desire to pursue permissible sexual relationships (Briken and Kafka 2007).
Neurointerventions, Recidivist Sex Offenders, and Situated Moral Agency: An Approach From the Margins
Published in AJOB Neuroscience, 2018
With the growing potential to address the biological conditions that lead to criminal behavior, scholarly engagement on the usage of mandatory neurointerventions as a condition of release from incarceration or as an alternative to incarceration altogether has increased in recent years. One of the most commonly implemented neurointerventions in the criminal justice setting has been the chemical castration of recidivist sex offenders. Chemical castration describes pharmacotherapy of males to reduce testosterone levels and is believed to significantly reduce the likelihood for recidivism, though few data support this claim (Basdekis-Jozsa et al. 2013).