• Surgery
• Behaviour Modification
• Coercion

In his thought-provoking article, John McMillan argues that the moral acceptability of offering surgical castration to imprisoned sex offenders depends partly on the state's intentions when making the offer.1 McMillan considers the situation where the prisoner will be detained for public protection for as long as he is considered dangerous and where the state and the offender both know that he may become non-dangerous sooner and qualify for early release if he accepts the offer of castration. Does the state, when presenting the offender with the option of castration, intend him to choose this alternative? Does the state intend that the possibility of being released earlier from prison will induce him to accept castration? For McMillan, it seems that if the answer to either of these questions is ‘yes’ then the offer is morally unacceptable. However, McMillan maintains that ‘the state need not intend that sex offenders are castrated’, and need not intend offenders to accept castration because of the prospect of early release (although, the state must foresee that some offenders probably consent for this reason).1 He concludes that castration may be ethically defensible provided other conditions are also met (in particular, that psychiatrists have good reasons for thinking that ‘castration will result in a person being able to reconstruct their agency’).1

While I am sympathetic to McMillan's claim that the state's intentions are morally significant, I believe that this claim requires more justification than he provides. McMillan argues that …