The Use of Coercive Chemical Castration and Its Impacts on Human Rights
Prevailing medical ethics and human rights have ruled that human dignity, human rights, and fundamental freedoms are to be fully respected. From this perspective, individuals are required to give informed consent prior to any medical procedure that they undergo. Various international laws protect the right to informed consent, including the UNESCO’S Universal Declaration on Bioethics and Human Rights and the WMA Declaration of Helsinki. Consequently, forced or involuntary use of anti-androgenic hormone treatment, commonly referred as chemical castration, raises serious human rights concerns, particularly in regards to the protection of the rights to physical integrity, health, and privacy. However, this practice has been implemented in several countries, such as Poland, Russia, and Estonia. Laws in eight states across the United States, including Texas, Florida, and California also allow compulsory medical treatment for sexual offenders,. The process can be done at a request of someone who wishes to control their libido, while also being used as a punitive measure to impair the sexual function of sexual offenders. Poland was the first nation of the European Union who allowed judges to impose chemical castration on some convicted paedophiles.
The process of chemical castration involves the administration of anti-androgenic hormone treatment that would reduce testosterone levels in the hope to reduce deviant sexual urges and the capacity for sexual arousal. The main drugs used are cyproterone acetate, medroxyprogresterone, and gonadotrophin. However, these drugs have negative adverse effects, including a metabolic syndrome and decreases in bone density. In addition to these risks, there has been no consensus opinion on the effectiveness of the treatment, as argued by Heim and Hursh. Rice and Harris, also reported that there has not been enough scientific or ethical debate for castration to be a fundamental aspect in the treatment of sexual offenders. Furthermore, chemical castration by itself is not capable to control sexual urges that are influenced by psychological problems. For instance, Berlin noted that chemical castration is ineffective in antisocial or psychopathic sexual offenders.
Several human rights organisation, such as Amnesty International, have been campaigning for the abolishment of chemical castration as a method of punishment. Chemical castration has over the years been criticised as a method of inhuman punishment. The treatment often does not have the consent of the patient and thus contradicts international human rights law. It is also a violation of human rights as ruled in the Convention against Torture and Other Cruel Inhuman or Degrading Treatment and Punishment. Moreover, there is a lack of correlational relationship between chemical castration and the elimination of child sexual abuse as there has been no evidence that the use of chemical castration would reduce the number of cases of violence against children. Unfortunately, despite many arguments to end this practice, in October 2015, the Government of Indonesia announced its plan to legalise chemical castration as a punitive measure for sexual offenders.
The Case of Indonesia
In recent years, Indonesia has seen an increasing number of cases of child abuses. Some of these cases have received wide spread attention, such as the case of the sexual assault committed towards a 5-year-old student at the Jakarta International School. The National Commission for Child Protection reported that in 2015, there were 2,898 cases of violence against children, 59.3 per cent of which were sexual offences. We should note, however, that the Indonesian Commission of Child Protection has not enough data nationwide to claim that there is an emergency situation in regards to child sexual abuse. It also lacks data on sexual recidivism of sexual offenders.
Despite the lack of data, the Government of Indonesia has initiated a draft of Government Regulation in lieu of Law on the Second Amendment of Law Number 23 Year 2002 on Child Protection. The Government is planning to amend Article 81 and Article 82 of the Child Protection Law by increasing the minimum imprisonment length from 5 to 10 years and legalising the use of chemical castration as an additional punitive measure. The Secretary-General of the Indonesian Child Protection Commission stated that the draft regulation is currently awaiting approval from President Joko Widodo. Some parties, including The Indonesian National Commission on Human Rights and the human rights coalition called Aliansi 99 have strongly opposed this plan.
There are various problems that would stem from the legalisation of chemical castration for sexual offenders. In the context of Indonesia, for instance, Aliansi 99 argued that since most sexual offenders are close to the victim many cases go unreported. The practice would thus not eliminate child sexual abuse. In cases where the sexual offenders are children, the problem is more complicated. Since even adults who volunteer to undergo the treatment cannot give a free consent as they face the pressure of incarceration, it is inappropriate to let children undergo such a treatment when they are not yet mature enough to give consent to any kind of medical treatment.
Furthermore, the problem of chemical castration in Indonesia also faces important technical issues, since the proposed law gives no clarity on how the chemical castration should be administered. Indeed, the entity responsible for authorising the treatment remains unspecified. The structure responsible for supervising the treatment, in order to insure that no adverse secondary health effects come about, is also unclear. Indonesia has a severe lack of mental health professionals, thus putting offenders at much higher risk as there are not enough people to monitor their medical conditions. Consequently, this further endangers offenders’ human rights. These issues demonstrate how the Government has not comprehensively researched nor has sufficiently planned the legalisation in regards to chemical castration.
The increasing cases of child sexual offences should not be a mere reason for the Government to justify inhuman punishment. In tackling the issue of child sexual abuse, it is highly important to consider careful steps and implement evidence-based legislation and policy that are proven effective to reduce the number of cases. The use of punishment alone is an inadequate deterrent for sexual offences. The policy should be based on a human rights perspective especially since Indonesia has ratified the International Covenant of Civil and Political Rights (ICCPR) and the Convention Against Torture and Other Cruel Inhuman or Degrading Treatment or Punishment through Law Number 5 Year 1998. Failure to uphold human rights by enacting discriminatory laws and practices has a negative impact towards the achievement of Sustainable Development Goals.
Given the significant risk of human rights abuses, Indonesia should not legalise the use of inhuman punishment and should instead start applying a restorative practices as a more effective means to reduce sexual offences. As a country that has theoretically been reinforcing its commitments to human rights, Indonesia should start allocating available resources to increase the use of alternative solutions to criminal justice. This should include prioritising rehabilitation process for sexual offenders and implementing counselling and other support mechanisms. Apart from applying restorative justice approaches for the offenders, rehabilitation and psychological treatment for victims of sexual abuse should also be provided as many sexual offenders themselves have a history of being victims in the past. The government should commit to implement a restorative justice principle in order to tackle issues of sexual offences at its roots.
Citta Widagdo is an LL.M. Graduate of University College London. She has previously interned in various charities and legal clinics, including work shadowing the Chief Medical Officer of England. Having lived with fibromyalgia and chronic fatigue syndrome, her research interests are health care law, public health policy, health and human rights, and bioethics governance with a particular focus on the European Union and Southeast Asia. She can be contacted at firstname.lastname@example.org.