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Biocriminal Justice: Exploring Public Attitudes to Criminal Rehabilitation Using Biomedical Treatments

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Abstract

Biomedical interventions, such as pharmacological and neurological interventions, are increasingly being offered or considered for offer to offenders in the criminal justice system as a means of reducing recidivism and achieving offender rehabilitation through treatment. An offender’s consent to treatment may affect decisions about diversion from the criminal justice system, sentence or parole, and so hope for a preferable treatment in the criminal justice system may influence the offender’s consent. This thematic analysis of three focus group interviews conducted in Canada with members of the public investigates how the public views the use of biomedical treatments within the criminal justice system, and the practice of encouraging offender consent to biomedical treatment through the hope of a reduced criminal sentence. The public focus group discussions followed a semi-structured interview guide, and were based on two hypothetical case examples involving individuals choosing whether to consent to a range of cocaine addiction or anti-libidinal treatments respectively in the hope of receiving a more lenient sentence. The discussions covered a wide range of themes, and here we present the participants’ evaluations of this type of biomedical treatment offer in light of three key theoretical sentencing objectives: the promotion of public safety, the infliction of retributive punishment, and the rehabilitation of offenders. We conclude that public safety was the predominant concern of the participants when evaluating biomedical treatment offered at the time of sentencing to offenders who had committed serious crimes. Another important observation was that the public tended to reframe and evaluate biomedical interventions in terms of retribution and punishment, rather than rehabilitation and reform.

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Author information

Authors and Affiliations

  1. University of Ottawa, Centre for Health Law, Policy and Ethics, Ottawa, Canada

    Robin Whitehead & Jennifer A. Chandler

Authors
  1. Robin Whitehead
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  2. Jennifer A. Chandler
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Corresponding author

Correspondence to Jennifer A. Chandler.

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Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Appendix Summary Sheet for Participants

Appendix Summary Sheet for Participants

Hypothetical Scenario # 1 – Violent offender and treatment of cocaine addiction.

  • A man with a serious addiction that contributes to his committing violent assaults consents to medication, vaccines, or brain surgery to treat his addiction.

Treatment 1: Oral medication that blocks the “high” of cocaine and decreases cravings.

  • Temporary effect (while medication is taken)

  • No known side effects.

Treatment 2: Injected vaccine that blocks the “high” of cocaine and decreases cravings by altering the immune system so that the amount of cocaine reaching the brain is reduced.

  • Permanent effects on immune system.

  • No known side effects.

Treatment 3: Surface magnetic stimulation of a part of the brain associated with addiction to decrease cravings.

  • Temporary effects (last between a few hours and a few days)

  • No known side effects.

Treatment 4: Mild electrical stimulation of a part of the brain associated with addiction using a small electrode that is implanted within the brain in order to decrease cravings.

  • Effects last while the stimulation is turned on.

  • The implant may be removed with a second surgery.

  • Brain surgery to implant the electrode has been used for many years to treat other medical problems. There are uncommon risks such as bleeding, infection, seizures or headaches.

  • Uncommonly, mood or personality changes may occur while the stimulation is turned on.

Treatment 5: Brain surgery using a fine electrical probe to destroy a small specific part of the brain associated with addiction in order to decrease cravings.

  • Effects are permanent.

  • Brain surgery like this has been used for many years to treat other medical problems. There are uncommon risks such as bleeding, infection, seizures or headaches.

  • Uncommonly, mood or personality changes may occur.

Hypothetical Scenario # 2 – Sexual offender and sex-drive reducing treatment.

  • A man who has sexually molested a child consents to either medication that reduces sex drive or surgical removal of his testicles to reduce sex drive.

Treatment 1: Medication that reduces sex drive by reducing testosterone levels temporarily.

  • Oral or injectable

  • Effects are temporary (while medication is taken).

  • Erections and sex are still possible, although sex drive is reduced.

  • Risks and side effects: Some report hot flashes, weight gain, which can lead to diabetes, osteoporosis, depression.

Treatment 2: Medication that reduces sex drive by reducing testosterone levels permanently.

  • Oral or injectable

  • Effects are permanent, although they can be countered by taking testosterone.

  • Erections and sex are still possible, although sex drive is reduced.

  • Risks and side effects: Some report hot flashes, weight gain, which can lead to diabetes, osteoporosis, depression.

Treatment 3: Surgical removal of the testicles (castration) that reduces sex drive by reducing testosterone levels.

  • Effects are permanent, although they can be countered by taking testosterone.

  • Permanent infertility, although sperm-banking before castration allows fatherhood.

  • Surgery is painless, and rubber implants can be used so there are no signs of the procedure.

  • Erections and sex are still possible, although sex drive is reduced.

  • Risks and side effects: Some people report hot flashes, weight gain, which can lead to diabetes, osteoporosis, depression.

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Whitehead, R., Chandler, J.A. Biocriminal Justice: Exploring Public Attitudes to Criminal Rehabilitation Using Biomedical Treatments. Neuroethics 13, 55–71 (2020). https://doi.org/10.1007/s12152-018-9370-y

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  • DOI: https://doi.org/10.1007/s12152-018-9370-y

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