Sumisión química en casos de presuntos delitos contra la libertad sexual 2016-2018, Lima, Perú / Chemical submission in cases of alleged crimes against sexual freedom 2016-2018, Lima, Peru

Introducción: La sumisión química es el uso de sustancias químicas con el fin de manipular la voluntad en las personas produciendo una incapacidad o inconsciencia que facilita la acción criminal, por lo que han tomado un gran protagonismo en los últimos años, debido al uso frecuente en los casos de presuntos delitos contra la libertad sexual.Materiales y métodosSe ha realizado un estudio observacional descriptivo-retrospectivo de casos de presuntos delitos contra la libertad sexual ejercidos mediante sustancias químicas, con el fin de determinar el perfil de las víctimas según las muestras analizadas y las sustancias detectadas en los años 2016, 2017 y 2018, que han sido registrados en la Dirección de Criminalística (DIRCRI) de la Policía Nacional del Perú (PNP).ResultadosDe los 1841 casos de delito contra la libertad sexual, 445 (24,17±2%) cumplieron los criterios de inclusión. El perfil de la víctima es de una mujer limeña joven con una edad media de 22,56±1,14 años. La procedencia de casos fue San Juan de Lurigancho (10,56±2,9%). Las muestras remitidas han sido orina (62,47±4,5%), y en conjunto con el sarro ungueal (37,53±4,5%). El análisis toxicológico de los casos probables han sido sustancias identificadas como psicofármacos (57,53±4,6%, fundamentalmente benzodiacepinas), etanol (26,29±4,1%), y drogas ilícitas (11,24±2,9%, fundamentalmente marihuana y cocaína), solas o en combinación.ConclusionesEl estudio demostró que el 24,17±2% fueron casos probables de mujeres limeñas, agredidas sexualmente bajo efectos de sustancias químicas, predominando el distrito de San Juan de Lurigancho con el 10,56±2,9%, cuya mayoría de muestras analizadas fueron a partir de la orina con el 62,47±4,5%; el grupo de sustancias en el que más prevalencia se obtuvo fueron los psicofármacos con 57,53±4,6%, siendo las benzodiacepinas los únicos subgrupos que fueron registrados. (AU)

Introduction: Chemical submission is the use of chemical substances to manipulate the will of a person, producing incapacity or unconsciousness that facilitates criminal action. It has gained in prominence in recent years, due to its frequent use in cases of alleged crimes against sexual freedom.Materials and methodsAn observational descriptive-retrospective study of cases of alleged crimes against sexual freedom committed using chemical substances was carried out, to determine the profile of the victims according to the samples analysed and the substances detected in 2016, 2017 and 2018,registered with the Criminalistics Directorate (DIRCRI) of the Peruvian National Police (PNP).ResultsOf the 1841 cases of crime against sexual freedom, 445 (24.17%±2%) met the inclusion criteria. The victim's profile is that of a young (Lima) woman (mean age: 22.56±1.14 years). The cases were from San Juan de Lurigancho (10.56%±2.9%). The samples submitted were urine (62.47%±4.5%), and urine and nail plaque (37.53%±4.5%). The toxicological analysis of probable cases showed substances identified as psychotropic drugs (57.53%±4.6%, mainly benzodiazepines), ethanol (26.29%±4.1%), and illicit drugs (11.24%±2.9%, mainly marijuana and cocaine), alone or in combination.ConclusionsThe study showed that 24.17%±2% were probable cases of Lima women who had been sexually assaulted under the influence of chemical substances, predominantly in the district of San Juan de Lurigancho at 10.56%±2.9%, most of the samples analysed were urine with 62.47%±4.5%; the most prevalent group of substances were psychotropic drugs at 57.53%±4.6%, with benzodiazepines being the only subgroups that were recorded. (AU)

Tratamiento hormonal de la pedofilia: ¿puede curar la pedofilia con la castración química? / Pedophilia hormonal therapy: can pedophilia be cured with chemical castration

Históricamente la sociedad ha rechazado el abuso sexual de menores de 13 años, dictándose leyes al respecto. La justicia luego de un debido proceso condenaba al victimario con reclusión incluso hasta la década del 70-80, con orquiectomía. Los adelantos en neurobiología, endocrinología, sicofarmacología y sicología se consideraron las bases para tratar al pedófilo y someterlo a libertad condicional, ahorrándose el costo financiero de la reclusión de por vida. Diversos países dictaron leyes contra la conducta pedófila. En dicha legislación ejerció gran influencia la promulgación en EE.UU. (estado de Washington "sobre el ofensor sexual" y el dictamen de la Corte Suprema en 1997 en el juicio de Kansas vs Hendricks). En Chile en los 90 el caso del pedófilo apodado "Zacarach" sacó a la luz pública el tema que no se quería ver. En esa fecha se presentó al parlamento un proyecto de Ley para "curar" la pedofilia con acetato de Medroxiprogesterona imitando legislación de EE.UU. Causó sorpresa en el medio endocrinológico que se usara terapia hormonal como "cura" de la pedofilia. Se ha utilizado en varios países la castración química producida por gestágenos o agonístas del GnRH más antiandrógenos (acetato de Ciproterona), para inhibir la secreción y acción de la testosterona disminuyendo líbido y erección. No se ha demostrado que exista curación de la orientación pedófila y existen dudas de la prevención primaria y secundaria de la pedofilia. Pese al adelanto tecnológico en neurociencias para estudio de las zonas vinculadas a la sexualidad, aún no existen marcadores que permitan diagnosticar o pronosticar futuros resultados de la terapia. El tratamiento médico de la pedofilia no garantiza curación ni prevención del delito pedofílico.

Historically, society has rejected sexual abuse of children under 13, with there having been laws enacted in this regard. The judicial system, after a due process, condemned the perpetrator with reclusion and even up until the decades of the 70s and 80s with orchiectomy. Advances in neurobiology, endocrinology, psychopharmacology and psychology were considered the basis for treating the pedophile and putting them on probation, saving the financial cost of imprisonment for life. Multiple countries have enacted laws against pedophilic behaviour. Such legislation was greatly influenced by the enactment in the USA (state of Washington "on the sex offender" and the ruling of the Supreme Court in 1997 in the trial of Kansas against Hendricks). In Chile in the 90s, the case of a pedophile nicknamed "Zacarach" brought to light an issue that nobody wanted to see. Around that time, a bill was presented to Parliament to try and "cure" pedophilia with Medroxyprogesterone acetate, imitating US legislation. It was a surprise in the endocrinological world that hormonal therapy would be used as a "cure" for pedophilia. Chemical castration produced by gestagens or GnRH agonists plus antiandrogens (Cyproterone acetate) has been used in several countries to inhibit the secretion and action of testosterone, reducing libido and erection. It has not been proven that there is a cure for pedophile orientation and there are doubts about the primary and secondary prevention of pedophilia. Despite technological advances in neurosciences for the study of the zones pertaining to sexuality, there are still no indicators that allow for diagnosis or prediction of future results of therapy. The medical treatment of pedophilia does not guarantee cure or prevention of pedophilic crime.

Sexual assault and abuse committed against family members: An analysis of 1342 legal outcomes and their motivations.

BACKGROUND: Over the past years medical centres specifically addressed in gender-based violence have developed protocols for the collections of evidence useful in the courtroom, including accurate documentation of physical and psychological states of the victim and collection of samples. Previous studies showed an association between documented physical trauma and conviction but unfortunately, few studies in the recent literature analysed the factors that influence the legal outcome and final judgement. The present study focused on the elements that appeared of significance in the legal outcome, including medico-legal evaluation, source of the crime report and circumstance of the assault. METHODS: It was conducted a retrospective analysis of all the judgments issued by the Public Prosecutor's Office at a Court of a Metropolitan Italian city regarding sexual and domestic violence, from January 1st 2011 to 31st December 31st 2015. Examination regarded the demographic information of the victim and of the defendant, information on the crime, the circumstances of the aggression and medical information retrieved. Sentences were subsequently divided into two categories based on the legal outcome (conviction vs acquittal) and the different characteristics of the two sub-populations were compared to verify if there were variables significantly associated to the judge's final judgment. RESULTS: Over the 5 years taken into consideration, there have been 1342 verdicts regarding crimes of sexual violence (374 cases) and regarding abuses against family members or cohabitants (875): other 93 cases regarded both sexual violence and abuse. 66.3% ended in conviction of the offender and 33.7% in acquittal of the accused. Cases of conviction were more frequent when they involved: use of a weapon by the assailant, as well as if the assailant had a criminal record and had a history of drug abuse or other addictions; duration of proceeding less 22 months and a civil party involved; presence of clinical documentation together with other deposition in addition to victim's deposition; also frequent episodes of violence and application of precautionary measures were associated to conviction. CONCLUSIONS: Many factors seem able to influence the judge's judgment, although clearly each case must be singularly evaluated. The mere presence of medical documentation, without the support of other sources of evidence, such as the victim's statement or further declarations, however, is almost always not definitive for the verdict. Despite so, in cases where there are multiple sources of evidence, clinical documentation can provide useful elements and can give clues on the consistency between the history told and injuries observed.

Coding of Sexual Assault by Emergency Physicians: A Nationally Representative Study.

INTRODUCTION: Sexual assault is a public health problem that affects many Americans and has multiple long-lasting effects on victims. Medical evaluation after sexual assault frequently occurs in the emergency department, and documentation of the visit plays a significant role in decisions regarding prosecution and outcomes of legal cases against perpetrators. The American College of Emergency Physicians recommends coding such visits as sexual assault rather than adding modifiers such as "alleged." METHODS: This study reviews factors associated with coding of visits as sexual assault compared to suspected sexual assault using the 2016 Nationwide Emergency Department Sample. RESULTS: Younger age, female gender, a larger number of procedure codes, urban hospital location, and lack of concurrent alcohol use are associated with coding for confirmed sexual assault. CONCLUSION: Implications of this coding are discussed.

Profiles of juveniles with sex offense charges referred for competence evaluations.

Juveniles referred for adjudicative competence evaluations make up a subset of youth involved in the juvenile justice system. Among those referred for adjudicative competence evaluations, a significant number involve youth with current or past charges for sexual offenses. This study examines the profiles of youth with sexual offense charges who have been referred for competence evaluations at a state psychiatric hospital for children and adolescents. Differences between the characteristics of youth with and without sexual offenses were explored, and predictors of competence opinions were examined among the subset of youth with current or prior sexual charges (juveniles with sexual offenses, or JSOs). Findings indicated that youth with sexual offenses have several demographic, cognitive, clinical, and legal differences from youth without sexual offenses. Although youth with sexual offenses were less likely to be opined competent, presence of a sexual offense was not a predictor of competence opinions after controlling for other factors. Predictors of competence among JSOs were found to be similar to those among youth referred for competence evaluations in general. Primary diagnosis of an autism-related disorder was a unique predictor of being opined not competent among the JSO subgroup, but not the overall sample. Implications for practice, policy, and research are discussed.

Violência em crianças, estudo de casos hospitalizados e seguidos nos serviços de Urgência de Pediatria e Medicina Legal no Hospital Central de Maputo em 2019 / Violence in children, a study of cases hospitalized and followed up in the pediatrics and forensic medicine emergency services at maputo central hospital in 2019

Introdução: Em Moçambique, anualmente, milhares de crianças são vítimas de violência, incluindo as suas formas mais extremas, como a violência física e sexual, o que compromete a saúde física e psicológica destas crianças. Objectivo: Analisar a violência nas crianças, em relação às características demográficas (da criança e do perpetrador), bem como descrever os aspectos clínicos da violência. Métodos: É um estudo transversal e retrospectivo, baseado em registos hospitalares dos serviços da Urgência de Pediatria e da Medicina Legal do Hospital Central de Maputo. Para a recolha de dados utilizámos o Formulário de Relatório de Casos Notificados. Foi utilizado o programa Excel® e testes de qui-quadrado para a análise dos resultados. Resultados: Identificámos um total de 329 casos de lesões relacionadas com a violência que afectaram crianças no Hospital Central de Maputo em 2019, dos quais 143 (43,5%) foram registados na Urgência de Pediatria e 186 (56,5%) na Medicina Legal. A violência sexual foi a forma de violência mais frequente (58% no total). Em ambos os serviços, as vítimas foram maioritariamente meninas do que meninos. As crianças mais velhas (11-14 anos) foram mais observadas na Medicina Legal (47,3% em comparação com 30,1% da Urgência de Pediatria) e as mais novas (0-5), na Urgência de Pediatria (37,1% em comparação com 28,6% a Medicina Legal). A violência sexual foi mais frequente entre as meninas em ambos os serviços, por outro lado, os meninos sofreram mais violência física. Os homens foram os principais perpetradores (81,8% no total) e a maioria deles eram conhecidos da família ou da vítima. As meninas sofreram lesões mais graves, exigindo cuidados médicos intensivos (12,0% em comparação a e 4,5% dos meninos). Em contrapartida, os meninos tiveram mais consultas médicas com alta imediata. As meninas tiveram de longe mais lesões genitais (66,4%) enquanto que os meninos tiveram mais lesões em todas as outras partes do corpo (cabeça, membros superiores, tórax e abdómen, membros inferiores e anal). Conclusões: A violência sexual foi a forma mais frequente de violência nos dois serviços. As meninas foram as vítimas de violência mais frequentemente descritas, tanto nos dois serviços como para a violência sexual em todas idades. Por outro lado, a violência física foi mais frequente entre os meninos. Os homens foram os principais perpetradores de violência especialmente da violência sexual, sendo estes, frequentemente conhecidos da família da vítima ou da própria vítima, é em vários casos um familiar. A casa da vítima ou do perpetrador é onde ocorreu a maioria dos eventos violentos. As crianças apresentaram várias lesões em consequência da violência sofrida, mas nem todos casos foram considerados graves. As meninas apresentaram lesões mais graves que exigiram cuidados médicos intensivos ou até cirurgia e os rapazes mais consultas médicas com alta imediata.

Introduction: In Mozambique, yearly, thousands of children are victims of violence, including its most extreme forms, such as physical and sexual violence, which hinders their healthy development. Objective: To analyze violence in children, in relation to demographic characteristics (child and perpetrator) as well as to describe the clinical aspects of violence-related injury. Methods: This study is cross-sectional and retrospective. Based on hospital records from the two services of Maputo Central Hospital, namely Pediatric Emergency and Forensic Medicine. For data collection we used a standardized Case Report Form. Excel® program and chi-square tests were used to analyze the results. Results: We identified a total of 329 cases of violence-related injuries affecting children at Maputo Central Hospital in 2019, of which 143 (43.5%) were registered at Pediatric Emergency and 186 (56.5%) at Forensic Medicine. Sexual violence was most common (58% in total). In both services, the victims were more frequently girls than boys. Also, older children (11-14 years) were more often seen at Forensic Medicine (47.3% compared with 30.1% at Pediatric Emergency) and younger ones (0-5), at Pediatric Emergency (37.1% compared with 28.6% at Forensic Medicine). Sexual violence was by far the most frequent among girls in both services, by contrast, boys suffered more physical violence. Males were the most common perpetrators (81.8%) and most of them were known to the family or the victim in both services. Girls also had more severe injuries, requiring intensive medical care than boys (12.0% and 4.5% respectively). By contrast, boys had more medical consultation with immediate discharge. Girls had by far more genital injuries (66.4%) while boys had more injuries in all other body parts (head, upper limbs, thorax and abdomen, lower limbs and anal). Conclusions: Sexual violence was the most common form of violence afflicting the children, most often girls, presenting at the two services. Sexual violence was most common among girls at all ages and physical violence, among boys. Men were identified as the main perpetrator, especially of sexual violence. The perpetrators were also very frequently known to the family of the victim, in several instances a relative. The victim's or perpetrator's home, is where most of the violent events take place. Multiple injuries were sustained but not all were severe. Girls had more severe injuries requiring intensive medical care and surgery, and boys, more medical consultations with immediate discharge.

The case for "investigate all": Assessing the cost-effectiveness of investigating no CODIS hit cases in a sexual assault kit initiative.

An increasing number of US jurisdictions have begun to submit their previously untested sexual assault kits (SAKs) for DNA testing. However, best practices for what should happen after testing are not well established. Should all cases be investigated regardless of the testing outcome or only those that returned a DNA hit? We examine an early-adopter jurisdiction that has completed testing and investigating all 5165 previously never tested kits. We explore and compare the criminal justice outcomes and cost-effectiveness of investigating: all cases, those with CODIS hits, and those without CODIS hits. Findings indicate the SAK initiative produced a cost savings to the community: $26.48 million ($5127 p/kit) after the inclusion of tangible and intangible costs of future sexual assaults averted through convictions, of which $9.99 million ($1934 p/kit) was from also investigating no CODIS hit cases. When considering only the costs to law enforcement, investigating all cases cost $12,000 p/additional conviction. Findings also illustrate the cost-effectiveness of investigating no CODIS hits cases and support an "investigate all" approach. This study enhances our understanding of the economic value of what comes after testing kits and investigating cases and provides a framework for jurisdictions for prioritizing resources and maximizing outcomes from testing.

Las personas con discapacidad intelectual como víctimas de delitos contra la libertad sexual: una realidad invisible / People with Intellectual Disability as Victims of Sexual Offences: An Invisible Reality

El presente trabajo tiene por objeto conocer los ajustes de procedimiento que se desarrollan durante los procesos judiciales ante hechos constitutivos de abuso o agresión sexual cuando la víctima presenta una discapacidad intelectual o del desarrollo (DID). Además, analiza las características de víctimas con DID y agresores, aportando información adicional sobre el proceso de denuncia. Para ello, se analizaron un total de 56 sentencias resueltas en un periodo de cuatro años (2014-2018), extrayendo informa­ción objetiva de las mismas con respecto a los aspectos más relevantes referidos a la víc­tima, el delito, el agresor y al proceso judicial. Del análisis realizado podemos concluir la existencia de multitud de obstáculos que aún siguen presentes en la práctica judicial española, siendo necesaria una formación exhaustiva de las personas vinculadas a los sistemas procesales en aspectos referidos a esta discapacidad: la víctima declara en reite­radas ocasiones, especialmente cuando se juzga un delito de agresión sexual, sin ningún tipo de adaptación o apoyo profesional. Señalamos asimismo la necesidad de evaluar la huella psicológica que pudiera presentar la víctima, así como desterrar mitos con respec­to a las discapacidades del desarrollo que dificultan el derecho a acceder y participar en los procedimientos judiciales en condiciones de igualdad

The following paper aims to analyze the provision of procedural accom­modations during the legal process to victims of sexual abuse or sexual assault with an intellectual or developmental disability (IDD). It also examines the characteristics of victims with IDD and their aggressors, providing additional information on the re­porting process. To this end, a total of 56 sentences resolved over a period of four years (2014-2018) were analyzed, extracting objective information regarding the most relevant aspects of the crime committed, the victim, the aggressor, and the legal process. The obtained results showed the existence of different obstacles that are still present in the Spanish jurisprudence, requiring an appropriate training for those working in the field of administration of justice: the victim declares repeatedly, especially when a crime of sexual assault is being judged, and without any type of accommodation or professional support. We also point out the need to evaluate the psychological consequences that the victim may experience, and to dispel myths regarding developmental disabilities that hinder access and participation in legal proceedings under equal conditions

Motivación y oportunidad en la explicación y prevención de los delitos sexuales / Motivation and opportunity in explaining and preventing sexual offences

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Prostitución, trabajo sexual, justicia y dignidad / Prostitution, sex work, justice and dignity

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The potential influence of criminological rationales in considering childhood abuse as mitigating to sentencing.

BACKGROUND: U.S. courts currently show no coherent approach with regard to how evidence of childhood abuse is considered in sentencing. Existing state and federal caselaw suggests that courts rarely place significant consideration on evidence of childhood abuse during sentencing, but the reasons why offenders who have been subjected to childhood abuse rarely receive mitigated or alternative sentences remain unknown. Yet literature has suggested it might be because no convincing rationales have been yet developed for the court in contending that penalties of offenders who were subjected to childhood abuse should be mitigated. OBJECTIVE: This research examines if and how criminological theoretical perspectives linking childhood abuse and later offending (Social Control Theory, Social Learning Theory, General Strain Theory) are persuasive in arguing childhood abuse (neglect, witnessing trauma, sexual abuse, physical abuse) as mitigating to criminal sentencing. PARTICIPANTS: A national sample of U.S. adults (N = 521). METHODS: A multi-factorial, vignette-based experiment was conducted, utilizing OLS and mediation analyses. RESULTS: Evidence on childhood abuse, and particularly sexual abuse, reduced support for incapacitation (B = -0.13, p ≤ 0.05) and increased support for rehabilitation (B = 0.16, p ≤ 0.01). Social Control Theory was particularly persuasive in arguing childhood abuse as mitigating to prison time and in relation to support for rehabilitative sentencing (mediated by beliefs regarding what the theory conveys about future dangerousness and reduced responsibility). CONCLUSIONS: Criminological theories appear to be persuasive rationales for arguing childhood abuse as mitigating to sentencing contexts involving incapacitation and rehabilitation. Implications for sentencing guidelines and systems are discussed.

Intrasexual Competition as a Predictor of Women's Judgments of Revenge Pornography Offending.

Recent legislative developments have led to a marked increase in the empirical investigation of motivations and judgments of so-called acts of "revenge pornography" offending. In two independently sampled studies, we used moderation analyses to investigate whether higher levels of intrasexual competition predicted more lenient judgments of revenge pornography offenses as a function of sex (Study 1, N = 241), and whether such relationships would be further moderated by physical attractiveness (Study 2, N = 402). Potential covariates of callous-unemotional traits, empathy, and victimization history were controlled for. Opposing our hypotheses, we consistently observed a trend for higher levels of intrasexual competition being associated with more lenient judgments of revenge pornography offenses involving male victims by female participants. The results are discussed in terms of intrasexual competition potentially sharing variance with unobserved constructs in the wider sexological literature, and of the key relevance of these findings for future empirical investigation into judgments of nonconsensual image-based offending.

Sexual abuse by superintending staff in the nineteenth-century lunatic asylum: medical practice, complaint and risk.

The nineteenth century witnessed a great shift in how insanity was regarded and treated. Well documented is the emergence of psychiatry as a medical specialization and the role of lunatic asylums in the West. Unclear are the relationships between the heads of institutions and the individuals treated within them. This article uses two cases at either end of the nineteenth century to demonstrate sexual misdemeanours in sites of mental health care, and particularly how they were dealt with, both legally and in the press. They illustrate issues around cultures of complaint and the consequences of these for medical careers. Far from being representative, they highlight the need for further research into the doctor-patient relationship within asylums, and what happened when the boundaries were blurred.

Characteristics of Older Adult First-Time Sex Offenders: Insights From the Missouri Registry.

OBJECTIVE: To explore the characteristics of older adult first-time sex offenders (who offended for the first time at the age of 65 years or above). DESIGN: The authors retrieved and analyzed data from the publicly available Missouri sex offender registry database up to December 2018 and the Missouri public case management system website. PARTICIPANTS: Registered older (≥65 years) sex offenders in the state of Missouri, United States. MEASUREMENTS: Sociodemographic characteristics of the offender, offense type(s), offense, and conviction dates; age and sex of the victim(s); and case disposition information (whether the trial was waived or not and what were the sentences imposed). RESULTS: One hundred and ninety-four older adult sex offenders all males were identified, of which 172 were first-time offenders. The majority were white; the median age of offense was 68.6 years old. One hundred and thirty-nine (80.8%) first-time offenders were convicted strictly of non-pornography offenses, with prepubescent girls the predominant victim pool. The most prevalent charge in this subgroup was Child Molestation, First Degree (36.5%). Twenty-eight (16.3%) offenders were convicted strictly of pornography offenses, the most prevalent one being Possession of Child Pornography (96.6%). The recidivism rate among first-time offenders was close to 1%. CONCLUSION: A substantial proportion of older registered sex offenders are first-time sex offenders and most of them have underage victims. Although the offense and recidivism rates seem to be low, future longitudinal studies should focus on the predictors of sexual offending in the older population, in order to design targeted preventive measures, risk assessment, and treatment options.

Beyond roofies: Drug- and alcohol-facilitated sexual assault.

ABSTRACT: Substance use in victims of sexual assault, whether voluntary or involuntary, changes the aftermath and recovery process significantly, affecting the way memories are processed and recalled, the chances of developing significant mental health complications, and the disclosure reactions that the survivor receives. Clinicians must understand these differences in order to provide the best possible care to survivors. This article provides an overview of these topics, detailing some of the nuances of interviewing, testing, and the physiology of memory formation and how that affects the outcomes of prosecution in these crimes.