Chemical castration for rapists

Health Care Comments Off

The Indian government is envisaging compulsory treatment of some sex offenders with antiandrogenic drugs, commonly referred to as chemical castration.

Laws in several American states allow compulsory medical treatment of offenders who have committed serious sex offences. Chemical, as well as physical, castration of sex offenders takes place in psychiatric hospitals in the Czech Republic under the legal framework of “protective treatment.” Meanwhile, in England, the Department of Health is supporting an initiative to facilitate the prescription of drugs on a voluntary basis for sex offenders in the criminal justice system.

Demand for the prescription of antiandrogens or physical castration for sex offenders is a common reaction by lawmakers and politicians when a high profile sexual crime is committed.

Whether medical or surgical, the procedure requires the participation of doctors. It also shifts the doctor’s focus from the best interests of the patient to one of public safety.

Antiandrogenic drugs and physical castration undoubtedly reduce sexual interest (libido) and sexual performance, and they reduce sexual reoffending.

Physical castration of sex offenders was carried out in several European countries in the first part of the 20th century.

Nowadays drugs are usually used alongside psychological treatment.

The main drugs used are cyproterone acetate (in the United Kingdom, Europe, and Canada); medroxyprogesterone (in the United States) and increasingly, the more expensive but possibly more potent gonadotropin-releasing hormone agonists such as leuprolide, goserelin and tryptorelin.

Although these drugs act in different ways, they all reduce serum testosterone levels in men to prepubertal values.

Castration, however—whether chemical or physical—is associated with serious side effects, including osteoporosis, cardiovascular disease, metabolic abnormalities and gynecomastia.

Physical castration is mutilating and irreversible, and it carries the potential for serious psychological disturbance, although some offenders request it nonetheless.

Is there a clear medical rather than social reason for prescribing powerful drugs?

When the intensity or ability to control sexual arousal is the presenting feature—whether it manifests as frequent rumination and fantasy or strong and recurrent urges—then treatment directed towards the biological drive makes sense.

Treatment protocols can then be based on the medical indication (remembering that drugs other than the antiandrogens, such as selective serotonin reuptake inhibitors, can also be effective, particularly when sexual rumination is the presenting problem) rather than on risk.

When drugs work, the clinical effect is often dramatic, with offenders reporting great benefit from no longer being preoccupied by sexual thoughts or dominated by sexual drive. These drugs can also allow offenders to participate in psychological treatment programmes where previously they may have been too distracted to take part. Given the transparency of benefits and risks, there is no obvious reason why an offender should not be able to make an informed choice about drugs. [Source BMJ, 2010]

Top Health News of 2012: From zombie attacks to soda-no-more

Health Care, Medicine Comments Off

[By Hope Gillette Voxxi]

1. New York City’s mayor placed a ban on large sizes of soda and other sugary beverages in an effort to help combat the nation’s growing issue with obesity.

2. The first ever over-the-counter home HIV test offered a way for early detection and thus earlier treatment, and was an important step in the war against the spread of AIDS.

3. Obesity was definitely a big fat health news in 2012 and one sure to roll over for the next few years.

4. Marijuana legalized in some US states

5. Meningitis outbreak: Contaminated steroid injections led to a number of deaths in the country and sickened thousands with fungal meningitis. In addition to the steroids, a number of other products, including ointments and creams, were recalled.

6. Energy drinks were linked to deaths

7. People all around the United States, as well as those in other countries, were made aware of the prevalence of genetically modified organisms in their food supply when a study on Monsanto corn products revealed negative health effects on laboratory rats. The ensuing actions led to the products being banned in certain parts of Europe and created a demand in the U.S. for better food labeling protocols.

8. Cranberry and UTI: The article touched on both the positives and the negatives of using cranberry juice, and warned of the possibility of interstitial cystitis, which mimics UTI symptoms.

Biggest Cardiology Stories of 2012 from Heart Wire- Cardiac surgery

Health Care Comments Off
  • The biggest advance this year in cardiac surgery in the US is the availability, under a few reasonable FDA conditions, of the Edwards transcatheter valve for inoperable and, more recently, very high-risk patients with aortic stenosis.
  • The requirement for a “heart team” in the selection of candidates for transcatheter aortic-valve replacement (TAVR) should ensure appropriate use of this technique.
  • FREEDOM trial results clearly demonstrate better five-year survival in diabetics with CABG as opposed to PCI, regardless of extent of coronary artery disease.
  • Initial results of the [National Heart, Lung, and Blood Institute's] NHLBI’s Cardiac Surgery Clinical Research Network’s [CTSN] Severe Ischemic Mitral Regurgitation trial comparing valve repair and valve replacement will be available in 2013.

« Previous Entries