Taming the Beast Within

Sorrentino also frequently gets letters from men being held under civil commitment at the Massachusetts Treatment Center within the Bridgewater Correctional Complex, a holding facility where such “sexually dangerous persons” undergo various therapy programs until they are deemed fit to re-enter society. Many of these men seek out Sorrentino for chemical castration as a possible conduit to their release. Enter the ethical juggernaut. In order to legally administer the treatment, Sorrentino needs to get informed consent from the subject. But, the state asks, can a man being held against his will produce such a thing? How does a doctor know if a patient truly wants to get treatment and better himself…or if he’s simply looking for a way out?

Last year, this quandary played out in the courts when Jeffrey Healey and Edward Given—two men held at the treatment center—filed a lawsuit against the Massachusetts Department of Corrections. Both had been deemed sexually dangerous after serving time for their crimes: Healey had been held at the center for four decades after being convicted of indecent assault and battery of a minor; Given had been at the treatment center for more than a decade for indecent assault and battery of a retarded person and the unnatural rape of a child. In their suit, they argued that the center’s therapies were inadequate, and that they wanted to be tested to see if they could receive Lupron. In April, U.S. District Court Chief Judge Patti Saris ruled in the men’s favor, finding that the department’s failure to rehabilitate people deemed sexually dangerous violated state law and the inmates’ constitutional rights.

Sorrentino did both men’s assessments. “In my eyes that is the absolute patient population that we want to be working on,” she says, and believes that ultimately, a person’s reasons for wanting treatment matter less than the fact that they’re willing to receive it. “As long as the person is willing to take it, I don’t really care what the reason is,” she says. “The bottom line is it decreases recidivism.” The case is currently under appeal, and representatives from the treatment center declined to comment, citing pending litigation and privacy laws surrounding the inmates’ care.

Whether Lupron is effective or not, many argue that convicted sex offenders have no right to treatment, particularly when it could result in their release from prison. “The thing with biological treatments, especially with chemical castration, is you’re relying on an offender to take their medication,” says Laurie Myers, the executive director of Community Voices, a victims’ rights organization based in Chelmsford. She says that both providers and offenders acknowledge there’s no way to tell for certain whether someone will reoffend while on these medications. “If they make a decision that they don’t want to molest kids or victimize someone, that’s wonderful. But you’re relying on someone, especially a pedophile, to make decisions as to whether or not they want to be sexually attracted to a child that day…. To say chemical castration will change what’s going on in these people’s heads is grasping at straws,” she says. “I don’t want them testing it on my kids.” To Myers, these treatments are too new, and too risky. She’d prefer to keep sex offenders under lock and key. Myers is also quick to note that putting more patients on Lupron therapies will help line doctors’ pockets.

For those who believe that providing Lupron to offenders is too merciful, treatment providers say that denying a patient a viable therapy is bad medicine. Saleh reasons that we should administer medication to those who have been diagnosed with treatable disorders, just as we give heroin addicts access to methadone to keep them—and the public—safe from harm. He says it’s a matter of public health. “If you compare the cost that goes into the assessment and management of the identified pedophilic sex offender…to the cost of creating a victim by their hands,” Saleh reasons, citing the distress caused not only to victims, but also to their families and the community, “…it’s ultimately less expensive to provide the treatment and management rather than just containment. On top of that, the most important part, in my judgment, is you potentially have a treatable condition. And if I can treat pedophilia or manage pedophilia with the right treatment, the number of victims is going to go down significantly.”

“Obviously there are those individuals who have the ‘Every sex offender needs a bullet in the head’ kind of view, which is a great way to stop recidivism, but is not really an ethical or justifiable way to conduct a criminal justice system,” says Kelly Socia, a criminal justice professor who studies the efficacy of sex-offender laws at UMass Lowell. He says the same logic can be applied to civil commitment. “You can have 100 percent reduction in sex-crime recidivism if you’re willing to lock up everybody for the rest of their life. But when you’re talking $50,000 to $100,000 to keep somebody in a secure mental-hospital-type environment, it’s just economically infeasible. And ethically there are some tricky issues that come with locking somebody up for that long.”

Sorrentino believes she has the tools to greatly curtail sexual abuse, but says she often finds herself hamstrung by the law, by a patient’s inability to pay, or both. And because so few doctors provide these treatments, she sometimes encounters ethically treacherous situations that leave her with little recourse.

One day, several years ago, a pediatrician came to Sorrentino seeking chemical castration. A self-described pedophile, the practicing doctor had been harboring sexual fantasies about prepubescent children for years, but told her that he had not acted upon them. He had been turned away for Lupron treatment by another Massachusetts physician, and Sorrentino knew that if she denied the pediatrician care, there was no other provider he could turn to. So she agreed to offer him treatment, but only under the condition that he suspend his license while he was her patient, thereby limiting his access to kids.

The pediatrician refused her terms. “I felt like I was going to be an impaired physician,” Sorrentino says. “I wasn’t sure if he was being honest about his access to children.” Because of the strict confidentiality agreement between doctors and patients, Sorrentino was powerless to warn the authorities or the parents who send their children to his practice. “I have people that are now calling me saying, ‘I have trouble managing my pedophilic desires, I don’t want to touch kids, I need help,’” she says, shaking her head. “And one of the difficult things is I’ve actually had to turn down a fair amount of these people.”