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Ethical issues

This bibliography describes what researchers and clinicians have written addressing ethical issues in four areas.

Annotated bibliography: Adult-minor sexual activity

Finkelhor, D., "What’s wrong with sex between adults and children?" American Journal of Orthopsychiatry, vol. 49, 1979, pp. 692-697.

Sex abuse researcher David Finkelhor discusses the issue of informed consent when adults engage in sexual activities with children who have not yet reached puberty. Because such children are ignorant about sex and sexual relationships and do not have true freedom to say yes or no, he writes that they cannot give informed consent to sexual activity with an adult. His argument is independent of whether or not the child would be harmed.

Li, C.K., "Adult sexual experiences with children," in Li, C.K., West, D.J., & Woodhouse, T.P., Children’s sexual encounters with adults, London: Duckworth, pp. 139-316, 1990a.

Psychologist Chin-Keung Li delineates and critiques the argument that rejects adult-minor sex based on the principle of informed consent. He then describes and criticizes an opposing argument that favors acceptance of consensual adult-child sexual interaction.

Sandfort, T., Boys on their contacts with men: A study of sexually expressed friendships, New York: Global Academic Publishers, 1987.

Dutch researcher Theo Sandfort describes how power worked in the man-boy sexual relationships he studied.

Schmidt, G., “The Dilemma of the Male Pedophile,” Archives of Sexual Behavior, vol. 31, no. 6, 2002, pp. 473-477.

Schmidt explains how adult-child sex conflicts with principles of consensual morality and sexual self-determination, particularly due to the child's lack of knowledge of adult sexual scripts. Like Finkelhor, he presents an argument separate from the question of harm to the child. He also discusses how society should view the pedophile.

Annotated bibliography: Treatment

Adams, J.K., "Court-Mandated Treatment and Required Admission of Guilt in Cases of Alleged Sexual Abuse: Professional, Ethical, and Legal Issues"*, Issues in Child Abuse Accusations, vol. 9, no. 3/4, 1997.

Clinical and forensic psychologist Judith K. Adams discusses ethical issues common to sex-offender therapy: use of unproven treatment methods, presumption of guilt, use of humiliation and confrontation, and lack of informed consent. She also addresses the therapist’s potentially unethical dual role as counselor and reporter to government authorities.

Crawford, D., "Treatment approaches with pedophiles," In Cook, M. & Howells, K. (Eds.), Adult sexual interest in children, London: Academic Press, 1981, pp. 181-217.

David Crawford of Broadmoor Hospital in England notes the conflict between the therapist’s role as enforcer of society’s standards and his responsibility to help his client adjust to, and cope with, his sexuality. He also notes the problem of obtaining free and informed consent in a criminological context.

Gieles, F.E.J., "Helping people with pedophilic feelings," Lecture at the World Congress of Sexology, Paris, June 2001.

Dutch therapist Frans Gieles raises ethical objections to sex-offender treatment for minor-attracted adults related to its goals, its view of the client, its intrusiveness, its control and suppression of thoughts and feelings, and its psychological effects.

Lee, F., "All fall down"*, Issues In Child Abuse Accusations, vol. 3, no. 1, 1991.

A man’s personal account of his experience in group therapy for sex-offenders.

Miller, J.G., "On Mitigating Professional Arrogance in the Treatment of Sex Offenders"*, Medicine and Law, vol. 11, 1992, pp.485-491.

The president of the National Center on Institutions and Alternatives discusses "debilitating ethical and scientific implications" that have resulted from the adoption of the adversarial criminal justice model rather than the helping model by sex offender therapists.

Annotated bibliography: Aversion therapy and sex-drive reducing drugs

Fog, A., "Paraphilias and Therapy," Nordisk Sexologi, vol. 10, no. 4, pp. 236-242, 1992.

Based on studies of behavior therapy and his own experience working with patients who have experienced it, sociologist Agner Fog addresses three ethical problems: the use of psychiatry to enforce social conformity, the potential for psychological trauma, and the attempt to control the patient’s mind.

Halleck, S.L., "Editorial: The ethics of anti-androgen therapy," American Journal of Psychiatry, vol. 138, no. 5 (May 1981), pp. 642-643.

Halleck addresses the issue of informed consent, and discusses the risks and benefits that anti-androgen treatment presents to society and to sex offenders.

Langevin, R., Sexual strands: Understanding and treating sexual anomalies in men, Hillsdale, NJ: Erlbaum, 1983.

Ron Langevin of the Clarke Institute of Psychiatry in Toronto briefly discusses the criticism that aversion therapy is inhumane and has no demonstrated effectiveness. He also notes difficulties of providing worthwhile treatment in the coercive environment of the criminal justice system.

Leinwand, S.N., "Aversion therapy: Punishment as treatment and treatment as cruel and unusual punishment," Southern California Law Review, vol. 49, no. 4 (May), 1976, pp. 880-983.

Leinwand briefly discusses the ethics of using aversion therapy in the criminal justice system.

Matson, J.L. & DiLorenzo, T.M., Punishment and its alternatives, New York: Springer, 1984.

This book presents a 1977 statement from the Association for the Advancement of Behavior Therapy intended to insure ethical use of behavior therapy techniques such as aversion therapy and covert sensitization. Matson & DiLorenzo elaborate on the issues related to treatment goals, informed voluntary consent, and situations where a person or agency is empowered to place a subordinate client in therapy.

Tsang, D.C., "Policing ‘perversion,’" Journal of Homosexuality, vol. 28, no. 3/4, 1995, pp. 397-426.

Daniel C. Tsang of the University of California discusses ethical issues surrounding the use of medroxyprogesterone acetate (Depo-Provera) in the treatment of sex-offenders, particularly regarding its dangerous side-effects, the lack of FDA approval, and the absence of informed consent.

Annotated bibliography: Scientific integrity

Okami, P., "Sociopolitical Biases in the Contemporary Scientific Literature on Adult Human Sexual Behavior with Children and Adolescents," in Feierman, J. (Ed.), Pedophilia: Biosocial Dimensions, New York: Springer-Verlag, 1990, pp. 91-121.

UCLA psychologist Paul Okami discusses failures of integrity in methodology and discourse in some of the literature on child sexual abuse, including incidents of character assassination against other researchers. He addresses purposeful bias and abandonment of scientific principles based on ideological grounds, the misleading findings and contradictory assertions which result, and their influence on social policy in ways that harm children and society.

Okami, P. & Goldberg, A., "Personality Correlates of Pedophilia: Are They Reliable Indicators?", Journal of Sex Research, vol. 29, No. 3, 1992, pp. 297-328.

Okami & Goldberg describe evidence that social advocacy concerns, rather than scientific principles, influence the design of many studies. They write that this may reflect a conflict of interest between scientific inquiry and the enforcement of social norms.

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