Henry_Stanley comments on An Exploration of Sexual Violence Reduction for Effective Altruism Potential - Effective Altruism Forum

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Comment author: Henry_Stanley 07 December 2017 11:36:50AM *  5 points [-]

Researching treatments for sexual offending has a chance to be the most cost effective option

I'm not convinced.

The Cochrane review on psychological treatments for sex offenders mentions a number of studies, each including hundreds of participants, that still weren't sufficiently well-designed to tease out a signal from the noise. Suffice it to say that this doesn't seem like a neglected area. It's not clear what low-hanging fruit there are re. psychological treatments; I doubt that the EA community is going to be able to run randomised controlled trials on hundreds of people at a cost of tens of millions of dollars given that many other scientists have failed to do so.

The other Cochrane review, on drug treatments for sex offenders, which shows that there's basically no evidence that e.g. testosterone-reducing drugs are useful and that there haven't been any RCTs published in two decades. So the fruit there are lower-hanging, but again, studies are going to be very costly.

As a meta-level aside, I'm also a bit worried about being too blasé about suggesting very radical interventions. From the Cochrane review:

It is a concern that, despite treatment being mandated in many jurisdictions, evidence for the effectiveness of pharmacological interventions is so sparse and that no RCTs appear to have been published in two decades.

So basically a bunch of places inject people with powerful hormonal drugs, against their will, with no evidence this will treat their problem. This is a clear human rights violation, and likely a violation of medical ethics too[1].

Given that we don't have any good evidence that testosterone-reducing drugs help sex offenders, I think it's a huge leap to then suggest investigating "testosterone reduction surgery" – by which I presume you mean castration. (You also say that sex offenders are likely to be willing to pay for their own treatment; something tells me most men aren't going to be willing to pay to be castrated.)

On an object level, this seems like a suggestion not worth taking seriously (there are a whole bunch of studies on testosterone-reducing drugs we'd need to do first before advocating sex offenders get castrated). And on a meta-level, I think outsiders with even the remotest sense of the unfairness of the criminal justice system would think us incredibly naïve to see us seriously suggesting performing surgery on sex offenders.

[1] http://jaapl.org/content/31/4/502.long - "When the promise of freedom is predicated on mandated treatment, the clinician must carefully assess the validity of informed consent."

Comment author: Marcus_N 07 December 2017 08:23:35PM 3 points [-]

This response is correct. Additionally, a major point I want to reiterate is that convicted sex offenders are a much narrower and more pathological group than any offenders who may exist in EA.

Even if medicalization and surgery was a successful and ethical intervention for convicted offenders—which you shed doubt on—it does not follow that such interventions would be helpful for other contexts, like corporations, academia, or EA. When sex offender are convicted using legal methods of due process, this is a much smaller and more pathological population than people who are accused under extra-legal processes, like corporate/academic kangaroo courts, or community witchhunts around he-said, she-said cases. This is not an apples-to-apples comparison of offenders or offenses.

Convicted sex offenders are a small and pathological group, and it is unlikely that there are many people who fit that profile in EA. It is likely that the vast majority of disputes over consent that might occur in EA will be misunderstandings, drunkenness, recklessness, or negligence, which does not rise to the level of intentional assault. It is both a statistical error—and a moral error—to suggest interventions designed for such criminal populations in one's own community. Unless, of course, one believes that their community contains a bunch of criminals.