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Name: Lieslmcq

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Chemical castration and autism

Posted: 4/7/2008 at 10:35 PM

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Before I begin, let me state that I will provide links at the bottom of the post rather than linking within the post. I think it's better in some circumstances to do that because it allows the reader uninterrupted reading. And I know y'all are just dying for some uninterrupted reading of my blog. What can I say? I'm just so danged magnanimous.

I've discovered something alarming: some parents of autistic children believe that their children should be castrated because they are of no benefit to society and it will make their lives easier. These people believe that it is for the benefit of the child that they perform chemical or surgical castration. It took me a good two days to get beyond the shock of this realization to be able to think about it rationally. Admittedly, it is a tiny minority of parents who feel this way. However, the fact that there are any is disturbing in the extreme. It is reminiscent of the 2004 case of parents forcing their child to undergo a complete hysterectomy at the age of nine. I'm getting a headache from thinking about these horrors.

In my research on the hysterectomy case I came across an article by the famous ethicist, Peter Singer. I teach Peter Singer in both my intro and ethics classes and I believed in his speciesism argument so heartily that I chose to become a vegetarian based on his book Animal Liberation. For the interest of clarity: I remained a vegetarian for 12 years, though I am no longer practicing vegetarianism. I have defended Peter Singer for years, as the most often reported criticism of his thinking is something that is taken so far out of context that it disconnects it from Singer's actual arguments. However, I must finally take issue with something he has written and the conclusions he has drawn:

"First, some say Ashley’s treatment is “unnatural” — a complaint that usually means little more than “Yuck!” One could equally well object that all medical treatment is unnatural, for it enables us to live longer, and in better health, than we naturally would. During most of human existence, children like Ashley were abandoned to become prey to wolves and jackals. Abandonment may be a “natural” fate for a severely disabled baby, but it is no better for that reason."

I agree that the unnatural argument is faulty. Singer is correct in his assertion that if we choose to call this unnatural we could very well call any interventional medicine unnatural. I think organ transplants are a prime example of the road we walk down if we choose to view interventional medicine as something outside of nature. However, at no time was abandonment "natural." I am guessing that Singer is assuming that human behavior is part of the natural world and it will therefore be termed as natural, no matter how it is enacted. That's the only assumption I can make based on the above statement. However, I think it is far more realistic to admit that human behavior is a product of a being that is part of nature but is not intrinsically natural, though it may possess and rely on some natural processes. I find that it is disingenuous to designate natural something as natural that is so variable and situational. If it is natural to leave severely disabled children out for the wolves why do we no longer do it? The fact that people used to do it does not make any claim on its membership in the natural club; people also used to poke holes in their heads to let out the bad humors. Finally, you can't call a thing natural if it does not exist in nature. Human behavior exists only after the fact. If you want to call the fact that I am going to get up and take some tramadol in a moment natural, then you have to find it in nature. The biological process involved in the action is absolutely natural as it involves all sort of natural processes in the undertaking of the action. The act itself, however, cannot be seen to exist in nature because it does not yet exist. It is a product of a natural process, not natural in and of itself.

"Second, some see acceptance of Ashley’s treatment as the first step down a slippery slope leading to widespread medical modification of children for the convenience of their parents... the “best interest” principle is the right test to use, and there is no reason that other parents of children with intellectual disabilities as profound as Ashley’s should not have access to similar treatments, if they will also be in the interest of their children. If there is a slippery slope here, the much more widespread use of drugs in “problem” children who are diagnosed as having attention deficit hyperactivity disorder poses a far greater risk than attenuating growth in a small number of profoundly disabled children."

Let me first state that I agree with his rendering of the use of the post hoc ergo propter hoc fallacy. That is a fallacy I think is used over and over and it is mostly based on nothing more than hysteria. There are times when a slippery slope can be reasonably demonstrated, but I do not believe this is one of those times. The best interest principle is indeed important in this issue. The question that must be answered is, whose best interest and which best interest is primary? Singer is arguing that the best interest of the individual family is the primary objective in the decision to castrate Ashley. What he fails to address is the best interest of society. This can be such a tricky little ditty to perform since it is impossible to divorce the family from society but it is possible to divorce their individual interests with those of society in a specific way. Over all, their interests equal the interests of society because society only has interests because individuals have interests. However, this contention falls short of the fact that society, while made up of individuals, is still something greater than an individual. That is why we look at the best interests of society in all cases; society has to trump the individual because we cannot have a society if we do not have societal standards. A bunch of people living near each other who do not agree on common standards does not a society make. Therefore, individual rights extend up to the point of harming society.

The question remains: was the castration of Ashley what is best for society? I think the answer to that question is a resounding "NO." In castrating a child we have set a standard for all children with severe disabilities that takes away their autonomy and rights as a part of society. This is not surprising as we often view children as property in our society. In the actions on Ashley's body we have asserted that severely disabled children will never have the rights we all enjoy as human beings; the rights to progress in a way that is in accordance with nature. That is not to say that we cannot help nature; we often intervene in an attempt to push us into normalcy and harmony with nature. In other words, we mitigate harm only when we endeavor to be healthy inside the parameters of what that means biologically. When we endeavor to go beyond those parameters we call it abuse. (steroids, anyone?) By implication, if we are impeding the natural progression of health then we are intervening in a way that is both abusive and indicative of a feeling of inferiority. Would we impede the growth of a "normal" child? Of course not. If that is the case, how can we possibly justify it for a severely disabled child? Treating children as equals is a large part of the reason we mandate inclusion in education and have changed the word "normal" to "typical" in our description of biological development. A-typical development alone is not a reason to class children as inferior or less deserving of rights, both natural and civil. If we continue to strip away the rights of the severely disabled we will profoundly change the meaning of equality in this country. In stripping away the rights of people who are not typical we make ourselves less accountable to them as a member of society and we would be deciding that there are qualifications for natural and civil rights other than your function as a member of a biological group. It is nothing more nor less than deciding that some people are better than others and therefore deserving of more rights. That alone should scare the pants off of you.

The harm to society is easily seen if we choose to place a value on whether or not a person is a typically developed or developing member of the human species. If we live in a society that asserts the natural and civil rights of all of its citizens (without the modification of behavior: law breaking), then we cannot possibly pick and choose people for enjoyment of those rights. The direct harm to society is in its citizens selectively enforcing the code of equality and rights for all human individuals who live in that society. No exceptions. In other words, if a right inheres itself to humanity then it inheres itself to everyone. The trespass on that right as a basic tenet of society is a trespass on society itself. For, you cannot have civil rights without society and you cannot have a just society if all members of that society are not bound by the same laws and standards. We've been through that nightmare before and we learned that it does not work and it does not allow for justice if justice is not applied equally. Personally, I don't want to live in a society that can take away my rights if they decide that I am somehow less equal.

I want to briefly address the "hyperactivity" statement: It may be true that we over prescribe drugs for ADHD. However, that does not mean that we should use that possibility to justify a position on an unrelated matter. It is a red herring and useless in the discussion of Ashley's case. It might also be true that we under prescribe medications for people in intractable pain. Does that have anything to do with the castration of Ashley? Only if you are discussing the pain she may feel from the castration itself. I would also like to point out that I am being very good and not going off on a tear over the implication that ADHD in children is somehow less deserving of mitigation. It's killing me, but I am staying on topic. For once.

"Finally, there is the issue of treating Ashley with dignity. A Los Angeles Times report on Ashley’s treatment began: “This is about Ashley’s dignity. Everybody examining her case seems to agree at least about that.” Her parents write in their blog that Ashley will have more dignity in a body that is healthier and more suited to her state of development, while their critics see her treatment as a violation of her dignity. But we should reject the premise of this debate. As a parent and grandparent, I find 3-month-old babies adorable, but not dignified. Nor do I believe that getting bigger and older, while remaining at the same mental level, would do anything to change that."

I find this argument perplexing. Human dignity is something that is never guaranteed us and it is something that is subjective at bottom. I don't think it's dignified to pick your nose in public; does that mean we should make that belief a part of an overall standard for human dignity? Of course not. Singer doesn't believe that 3-month-old babies are dignified, but he goes on to state that dogs and cats are; that's his choice to make but it is not something that is inherent to the beings themselves. Rather, it is a label we assign to particular characteristics wherever we find them. Singer argues that dogs and cats function on a higher cognitive level and that dignity is not species specific. I agree. However, that does not automatically mean that there is such a thing as dignity for all species in all ways at all times. It is still only a label or an action that we choose to place on other things. We might call a sermon dignified, or a grove of trees, or a member of a royal family. But we would not assign dignity to any basic human characteristic as it is something only gotten at through perception. So, my question must be: what does dignity have to do with it? If she has dignity it is only in the eyes of the people who assign that label. This is not to say that we want to do away with our ideas on dignity; however, thinking that an idea is a good thing and beneficial to society is not the same thing as claiming it is inherent in the same way to all people, places and things and in all situations. Put simply: dignity only matters in this case insofar as it is a lens through which we may be individually helped to understand the inherent biological and civil realities of the case.

"What matters in Ashley’s life is that she should not suffer, and that she should be able to enjoy whatever she is capable of enjoying. Beyond that, she is precious not so much for what she is, but because her parents and siblings love her and care about her. Lofty talk about human dignity should not stand in the way of children like her getting the treatment that is best both for them and their families."

Singer's statement about Ashley's worth being measured by the love of other people for her is as close to evil as I have ever seen from Singer or any other philosopher. The idea that our worth is measured in the way other people feel about us and therefore the enjoyment we provide others is incredibly offensive. What happens to the person who is not enjoyed by other people? are they worthless? According to the Singer argument, you bet your curmudgeonly ass they are! How would we measure this worth? If person A has three best friends who love him and person B only has two, is person A worth more as a human being because he has a greater quantity of love and is able to spread the enjoyment people get from his existence around a bit more? This cannot be! I find that this thinking is the very foundation of the rest of Singer's misguided attempt to take away the rights of the severely disabled. If you cannot prove worth in the person themselves then their worth should only be dependent on the people who get some benefit from them, or so Singer would have us think. Not only does that violate the principle of not using people as a means rather than treating them as an end, (Kant) but it allows for worth to be measured by something that is not inherent in the biological facts of humanity. It is utterly devoid of objective standards and it will easily lead us to excuse our actions based on the actions of others. If human worth could be so easily assigned and removed it would easily lack any real place in our lives and it would wrest control of our lives from us and give to others. The problems with this line of thinking are simply too much to bear.

Clearly it is our duty to ensure the rights of all people in our society. Why we still view children as less deserving of those rights is beyond me and endemic in the thinking that people are unequal itself. That is not to say that children should not be protected, but you cannot "protect" a child right out of their natural or civil rights. Once you abridge those rights you have left the realm of protection and galloped into the land of usurpation. When we endeavor to interfere with the rights of citizens then we choose to murder the sovereignty of all people in society by asserting that it is minor enough to brook contempt. We can never allow this thinking to prosper in our country as it once did in the form of eugenics. If we value our rights, our sovereignty, and our place in society we must stand firm against the injustice done to our least productive members as well as our most prominent. By definition equality cannot impose limits; it's nature and purpose are to free us from the constraints of arbitrary subjectivism and guarantee the recognition of basic rights.

Peter Singer's editorial
Ashley's parent's blog
Animal Liberation, by Peter Singer

I refuse to link to the people who believe their autistic children are deserving of chemical castration. They do not deserve the legitimate recognition. Additionally, I use the word "castrate" in this case because it describes an unwilling act, in my opinion. I do not think women who choose to have a hysterectomy (as I am one of them) are castrated. For the purposes of this post, castration and surgical intervention are two separate concepts.

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ADHD Report» Blog Archive » Chemical castration and autism wrote on Apr 7, 2008 at 11:54 PM
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Pingback from ADHD Report» Blog Archive » Chemical castration and autism
Chemical castration and autism at adhd advice.net wrote on Apr 8, 2008 at 12:24 AM
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Pingback from Chemical castration and autism at adhd advice.net
Blizej Natury » Blog Archive » Chemical castration and autism wrote on Apr 8, 2008 at 12:55 AM
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Pingback from Blizej Natury » Blog Archive » Chemical castration and autism
Chris wrote on Oct 20, 2008 at 7:54 AM
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Father of 2 Autistic Sons ........, In terms of Special Needs Families and severe Autism, I think the author of this article has completely missed the point and preaches without any real understanding of the heart-break this difficult subject causes many loving Parents ; I am the Father of 2 Autistic Children, the eldest is high functioning and in time we hope he can overcome his particular elements of challenging behaviour and form a meaningful relationship with a girl of his choosing, whilst enjoy all the fruits and wonders of a sexual relationship in a responsible manner. Our Youngest sadly is the opposite, he has just passed his 7th birthday, his speech is limited to a few audible sounds and mostly screams day and night. We have recently been informed that he has a mental age of 18 months and this is not expected to change. Our little lad literally lives in his own world, rarely visiting or interacting with us, ...., it breaks my heart to say this, yet he is extremely violent and strong. He takes whatever he wants in the way of food or toys, if he doesn't get it he goes beserk ...., from totally calm, there is no in-between, no getting angry, no warning. When he attacks it is like a pitbull, he bites ...., I do not mean just a nip but a mouthful ...., over the past 18 months I have lost the tip of a little finger, skin flesh nail and bone, the nail of a middle finger and both my wife, son and I have sustained tissue damage to our arms. When frustrated, usually around 20-30 times a day he also self-abuses biting his left hand, so badly he is permentantly scared with nerve damage to his thumb. The more it hurts the harder he bites. This week I took the heart-breaking decision to investigate on line the prospects of either chemical or surgical castration ..., and found we are not alone ...., this has been the hardest thing I have ever had to do ....,as I am writing this I am literally fighting back the tears ...., What other choice do I have ? He will not wear clothes ..., he disrobes in public ...., With his mindset in his own World, can you imagine what will happen when he becomes sexually active ? ...., if he sees a woman who he wants to touch, fondle and rub himself against, yet will never understand or take "No" for an answer ....., what would the outcome be when he is 25, 6'2" and 15 stone, the woman tries to fight him off and he starts to bite ....., Having read numerous medical articles, castration may actually be beneficial, it virtually eliminates testosterone, reducing violent behaviour, anger and self abuse. ..., I support the author in many of her views regarding Sexual Predators and Rapists ...., however when it comes to severely challenged children with Autism ...., you need to rethink your views ...., Do not judge the Parents, just thank your lucky stars you are not in this god-awful predicament ...., a little empathy and support would not go a miss I would love to stick my head in the sand, yet I know this dilemma will not go away, as a loving Parent, how can I condemn my innocent little son to a lifetime of being labelled and treated as a Sexual Menace or worse ...., From the perspective of a responsible citizen, how can I condemn a girl, woman or even a man to a frightening sexual assault in the future ...., "what choice do we have ???"
Tobias Holbrook wrote on Oct 30, 2008 at 9:06 AM
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Are you sure castration would be a good idea in that case, Chris? Males who have been castrated before puberty generally grow larger than those who aren't. Perhaps you should investigate a reversible castration? Maybe a course of Antiandrogens instead, to neutralise the effects of Testosterone? If you are worried about him becoming Sexually active, perhaps a diet of soy may help (although there are a few problems with the Thyroid from that). I know that some monks use it to prevent sexual desire.

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Chemical castration and autism

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