Should the Czech Republic stop surgically castrating sex offenders?

The Czech Republic has recently been criticized by the Council of Europe for surgically castrating sex offenders. Last year, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment visited several of the country’s psychiatric wards and prisons. In its report, the committee called surgical castration a degrading form of treatment, and recommended that Czech authorities abandon it. But most Czech sexologists and health care professionals disagree. They believe that surgical castration is the most effective form of preventing relapses. In this week’s Talking Point, we look at the practice, and the future, of surgical castration in the Czech Republic.

Aleš Butala
Last year, the Czech Republic was shocked by a case of child rape and murder. In May 2008, a 43-year-old Slovak national, who had been previously sentenced in his country for various sex offences and had been avoiding treatment, lured a nine-year-old boy into his apartment in Havlíčkův Brod, eastern Bohemia. After raping him, he took him to a forest outside the town where he strangled him. The boy’s body was not discovered until the police arrested the rapist. Last month, the man was sentenced to life imprisonment, and applied for surgical castration.

The Czech Republic is apparently the only European country where this method is still used in the treatment of sex offenders.

The murder took place a month after a visit by a leading European anti-torture body to the Czech Republic. The European Committee for the Prevention of Torture, part of the Council of Europe, reviewed the practice of surgical castration in the country. Their conclusion was unequivocal – the Czech Republic should abandon the practice, which they deemed “degrading and mutilating”. Aleš Butala headed the committee’s visit to the Czech Republic. Over the phone from Ljubljana, Mr Butala explains the committee’s views.

“This was not the first time the committee visited the Czech Republic but the main purpose of this visit was to monitor the implementation of surgical castration. The reason for the visit was the view of the committee that surgical castration of detained sex offenders amounts to degrading treatment. Let me say that surgical castration is a mutilating, irreversible intervention and cannot be considered a medical necessity in the context of treatment of sex offenders. The intervention removes the person’s ability to procreate, and has serious physical and mental consequences.”

The use of surgical castration in the Czech Republic is regulated by a law dating from 1966. One of the most important conditions is that patients willing to undergo the surgery must give their informed consent. The committee found, however, that in several hospitals, patients were given study material in foreign languages. In one of the institutions, the staff failed to provide the committee with a leaflet they said they give to the patients to inform them about the treatment.

“Any medical treatment should be based on free and informed consent. And when you deal with a medical intervention such as surgical castration – an irreversible intervention which always leads to infertility in the long run and has many side effects, for example mental depression, altered physical appearance, that’s even a more valid reason to have a free and informed consent. But surgical castration [in the Czech Republic] is applied to prisoners or to patients in psychiatric hospitals who in reality have just one option. They can either remain deprived of their liberty for the rest of their lives, for instance, or apply for surgical castration.”

The country’s leading sexologists have a different view of the controversial method. They say it’s effective, and it’s also more humane for the patients themselves – if the follow-up therapeutic treatment is successful, patients can return to the society and lead normal lives.

Miroslav underwent surgical castration more than seven years ago, after he brutally killed a woman who, he says, was bothering him. After the operation, he was released.

Photo: Filip Jandourek
“I underwent castration in September 2001. Now I feel ok, I feel balanced. My motivation was to come back to society, to lead a normal life, to get a job, find a partner and live with her.”

Professor Petr Weiss is a psychologist at the Institute of Sexology at Charles University. He says offenders like Miroslav are proof that surgical castration works.

“Surgical castration is the most effective method to prevent recidivism of sex offenders. In the Czech Republic, we have experience with castration for the last 40 years, and there is no patient who has relapsed after this treatment. Surgical castration may only be implemented voluntarily, of course, and under the informed consent of the patient and on his demand. It should only be applied in rare cases, with the most dangerous sex deviants, especially sadists and paedophile sadists.”

That is indeed the view of the Czech authorities, including the Czech Republic’s Health Ministry. In a response to the committee’s findings, the ministry said that “the operation is performed upon the written request of an adult man”. But Mr Butala says that this is not always the case. What’s more, he says surgical castration has also been applied to non-violent first time sex offenders. The committee believed that surgical castration was overused.

“According to the first deputy health minister of the Czech Republic, there have been 94 sex offenders sentenced to protective treatment who had undergone surgical castration. Surgical castration was applied not only to sexual re-offenders but also to first time offenders who had committed various offences. Some of them committed offences that were non-violent, such as for instance repeated exhibitionism. In at least five cases, legally incapacitated offenders were surgically castrated, and the consent form was signed by the court-appointed guardians.”

With regard to all this, the committee recommended that the Czech Republic immediately abandon the practice of surgical castration.

“The conclusion of the committee was that surgical castration of detained sex offenders amounts to degrading treatment, and that’s why the committee asked for an immediate end of the application of surgical castration in the context of treatment of sex offenders.”

On January 1, the first centre for the criminally insane opened in Brno where people who pose a permanent risk to society are detained. Mr Weiss says that if surgical castration is not used, long-term detention will be the only option. But he has his doubts on whether in fact this will be good for the patients.

“When this Committee talked to us, the Czech Parliament passed a new law on detention. So from January 1, we have the first detention institute for permanently dangerous and mentally disturbed offenders. Not just sex offenders, but psychiatric cases as well. And I think that in the future, these people who are permanently dangerous for the society – in the past, they would have undergone surgical castration and would have been released after some six months of further therapy. But now these people will spend many years, maybe decades, and maybe their whole lives, in such institutes. So this so-called humane, but in fact pseudo-humanistic recommendation of the Committee will in effect turn against our patients.”

In response to the report, the Czech authorities are going to establish a commission of their own to investigate the practice. But no matter what the commission finds, Petr Weiss thinks that the Czech Republic will eventually stop surgically castrating sex offenders.

“We will have to implement this recommendation, because I don’t think that we want to be troublemakers of the EU. If they think the treatment is not humane enough, so be it. I don’t think we have to continue.”