Treating the Sex Offender

This is an interesting story picked up by the BBC: drugs are being used to “suppress sexual thoughts and urges” among sex offenders in an experiment at HMP Whatton.

It is early days, and the number taking part is small – so far fewer than 60 – but the graphs illustrating such measures as prisoners’ strength of sexual urges, or time spent thinking about sex, all show a downward trend.

The Ministry of Justice is pleased with the initial evaluation of the scheme. The treatment will continue to be available to high-risk sex offenders who are assessed as being suitable, it says.

There’s all manner of questions raised by the prospect of using drugs to alter, reduce, or otherwise manipulate sex drive.  One thing that we should probably get out of the way first is to concede that there’s a slightly unfortunate history of chemical interventions into sex crimes: Alan Turing chose chemical castration over prison after his conviction for indecency – that is, for having had a sexual relationship with another man.  Still, I take it there’s enough of a difference between a consensual relationship and the kind of sex offence for which people can be imprisoned today to make that kind of parallel worth noting, but not worth worrying about too much.  Consent makes a big moral difference, and a legal one as well – R v Brown notwithstanding.

At the same time, there might be questions about the moral difference between having a certain sexual fantasy in the privacy of your own head, and acting it out.  I assume, for example, that there could be someone who seeks psychiatric help because (say) he finds himself attracted to children and is revolted by that attraction, but who has adequate moral self-control and presents no actual threat.  (Such “mere fantasists” would seem to be possible, though they might never be particularly noticeable simply because mere fantasy is as far as things get.  The psychology seems, at first glance, not to be too different from that of someone who genuinely wants to vandalise her boss’ car, but who has the self-control not to; I’ll take it that decent people do not always have virtuous desires, but that they generally do refrain from giving vent to them – and the ability to regulate their own behaviour whatever their id throws at them is one of the  things that guarantees their decency to begin with.)  Whether it’s permissible – or desirable – to use chemical interventions on such a person is a big question in its own right.  However, it’s one that I’m going to leave hanging for the moment.  This is partly because the fact that someone is in prison for rape, assault, or something of the like is sufficient to show that we’re dealing with someone whose private proclivities have spilled over into the public realm.  And it’s partly because there’re other questions worth raising.  (This is a post that’s more about questions than answers…)

The possibility of such procedures ought to be of interest to people working on moral enhancement.  Suppose that someone takes drugs in order to alter their sexual behaviour for the better (by which I mean to calm, say, violent paedophilic fantasies – which I’ll take as read as being for the better – rather than to try to make themselves heterosexual – which I’ll take as read as not being for the better).  Is that moral enhancement?  I suspect that, by at least some standards, it would be.  The “Oxford account” of moral enhancement focuses on the production of desirable inclinations and the suppression of undesirable ones (for more on which, see, inter alia, the papers by Tom Douglas and by Ingmar Persson and Julian Savulescu in the Journal of Applied Philosophy’s special edition on enhancement here, and Tom’s paper in Bioethics here).  Pharmaceutical modification of inclination could, quite easily, count as enhancement on this front.  By contrast, there’s an understanding of moral enhancement advanced by people like John Harris and Sarah Chan that insists on the importance of being “free to fall”.   (See here and here, for example, for their rebuttal of the Oxford account.  I don’t want to call that the “Manchester account”, since my own problems with the Oxford account differ from John and Sarah’s, and I am a Manc.  Having said that, though I’m not in the habit of publicly agreeing with John, I do think he’s right to find flaws in the Oxford account, and his and my accounts are, at least, not antagonistic.  I’ve given my own account its first outing at an iSEI research seminar, and hope to publish it soon – but it’s not something I’d want to go into here, beyond waving vaguely in the direction of Aristotle and John McDowell, and saying that the kinds of appeal to freedom that John makes don’t really move me.)

The question here turns on whether free will is threatened by pharmaceutical intervention, and whether that matters for the sake of making someone a better person anyway.  (The prison chaplain in A Clockwork Orange asks Alex whether god wants woodness or goodness.  It’s a version of the same question.)

Some might worry that offering drugs implies that being a sex-offender is a symptom of a certain kind of pathology – in which case, punishment might be inappropriate.  Indeed, offending behaviour might be taken to be not immoral, but amoral.  It’d only be immoral if the offender had any control over what he was doing; and if brain-chemistry was at the root, then he might not have that control.  Indeed, punishment might be immoral on that front.  (Nietzsche makes a claim somewhere that free will was invented so that we could punish…)  Detention might not be unacceptable for all that: we could still think that some people ought not to be free, simply because they are dangerous in the kind of way that doesn’t attract moral censure.  But punishment might take things too far.  This is likely to be an uncomfortable thought for at least some: it seems to let the offender off too easily.

It’s also a bit uncomfortable for the non-offender.  If being an offender is attributable to brain-chemistry, why would being a non-offender be different?  That is, if brains take away the blame, don’t they also take away the credit?  (Maybe we would want to say that free will is a characteristic of healthy brains, and its absence a pathology.  But that would require argument; it’s at least possible to say it’s all about the neurochemistry.)

On the other hand, such worries do look moralistic.  If sex-offending is indicative of a certain dysfunctional brain-state, then the fact that this challenges certain intuitions about offenders is neither here nor there.  More work needs to be done on establishing the link between pathology and behaviour, but we should follow the science where it leads us.

We would then have to confront questions about whether it really is desirable to punish at least some offenders, and about whether treatment with drugs could ever be banked against time served in prison – and about whether public protection might give us a reason to treat other people identified as having the “wrong” sort of brain-chemistry, possibly by force, before they get the chance to offend.

Going into these questions gets us very quickly into deep water.  But, if we’re already using drugs to treat, or to attempt to rehabilitate, sex offenders, they’re questions that we probably ought to be asking – and trying to answer – quite urgently.