A CASE STUDY PROVIDES THE BASIS FOR THIS EXAMINATION: TWO CONVICTED CALIFORNIA CHILD MOLESTERS REQUESTED CASTRATION AS AN ALTERNATIVE TO INDETERMINATE SENTENCES IN PRISON, BUT THE PHYSICIAN WHO HAD ORIGINALLY CONSENTED TO PERFORM THE OPERATIONS WITHDREW IN THE WAKE OF A LAWSUIT AGAINST A SURGEON INVOLVED IN A SIMILAR CASE. THE CONTROVERSIAL ASPECTS OF V0LUNTARY CASTRATION INCLUDE: (1) IS SURGICAL CASTRATION EFFECTIVE IN MODIFYING COMPULSIVE SEXUAL BEHAVIOR? (2) ARE PRISONERS TRULY CAPABLE OF GIVING FREE AND INFORMED CONSENT WHILE STILL CONFINED AND WITHOUT OTHER PROSPECTS FOR RELEASE? (3) WAS THE PHYSICIAN RIGHT IN REFUSING TO PARTICIPATE? THE PSYCHIATRIST IS OF THE OPINION THAT THE PRISONERS HAVE BOTH THE RIGHT AND THE ABILITY TO CHOOSE EITHER SURGICAL CASTRATION OR PHARMACOLOGICAL TREATMENT OVER LIFELONG CONFINEMENT. HIS VIEW THAT BILATERAL SURGICAL ORCHIDECTOMY IS EFFECTIVE IN REDUCING THE LIKELIHOOD OF FUTURE SEX OFFENSES IS BASED ON EVIDENCE TAKEN MAINLY FROM SCANDINAVIAN STUDIES. CONCERNING THE SURGEON'S REFUSAL TO OPERATE AFTER RECEIVING ADVICE FROM HIS MEDICAL COLLEAGUES, THE PSYCHIATRIST FEELS THAT THE MEDICAL SOCIETIES IN QUESTION ACTED INAPPROPRIATELY AND WERE INFLUENCED BY THEIR CONCERNS ABOUT MALPRACTICE INSURANCE. THESE CONCERNS COULD BE RESOLVED THROUGH LEGISLATION OR COURT DECISIONS AUTHORIZING THE CONDITIONS UNDER WHICH PHYSICIANS MAY PARTICIPATE IN SUCH PROCEDURES. THE PROFESSOR, HOWEVER, FEELS THAT CONFIDENCE IN CASTRATION FOR ELIMINATING OR REDUCING THE DANGER OF RECIDIVISM IS MISPLACED BECAUSE THE EVIDENCE AVAILABLE IS SCANTY AND INCONCLUSIVE. ON THE QUESTION OF CONSENT, HE PREFERS NOT TO DISCUSS WHETHER IT IS POSSIBLE, BUT WHETHER IT IS DESIRABLE. THE POSSIBILITY OF THIS OPERATION BEING PERFORMED ON UNWILLING PERSONS IN THE FUTURE IF IT IS PERFORMED ON THOSE NOW DESIRING IT IS ALSO OF CONCERN. ON THE ASSUMPTION THAT THE TWO PRISONERS ARE SIMPLY BUYING FREEDOM, HE IS OPPOSED TO SUCH EXCHANGES AND PREFERS TO EXPLORE ALTERNATIVES SUCH AS AVERSIVE BEHAVIOR MODIFICATION OR ANTITESTOSTERONE DRUGS.