Penile plethysmograph
Encyclopedia
Penile plethysmography or "phallometry", refers to measurement of blood
flow to the male genital
. The most commonly reported methods of conducting penile plethysmography involve the measurement of the circumference of the penis with a mercury-in-rubber strain gauge, or the volume of the penis with an airtight cylinder and inflatable cuff at the base of the penis. Cavernous nerve penile plethysmographs measure changes in response to inter-operative electric stimulation during surgery. The volumetric procedure was invented by Kurt Freund
and is more accurate than is the circumferencial procedure which was developed soon afterward. The simpler circumferencial procedure is the more commonly used, however.
For sexual offenders it is typically used to determine the level of sexual arousal
as the subject is exposed to sexually suggestive content, such as pictures, movies or audio. Although there are individuals who have claimed that phallometry is not always appropriate for the evaluation of sexual preferences or treatment effects, large-scale meta-analytic review of the scientific reports demonstrated that phallometric response to stimuli depicting children is the single most accurate (with 32% accuracy) method of identifying which sexual offenders will go on to commit new sexual crimes.
For prostatectomy
nerve-sparing surgery
, the surgeon applies a mild electrical stimulation near the cavernous nerves of penis
to verify their locations and avoid operative trauma. Damage to these difficult to see nerves can cause erectile dysfunction
outcomes. At the surgery's conclusion, the electrical stimulation penile plethysmograph result is a prognostic which helps to manage the erectile function outcomes earlier than the many months required for recovery.
The circumferential type is more common, but the volumetric method is more accurate.
Significant suppliers of PPG machines include Behavioral Technology Inc. and Medical Monitoring Systems. The device is known to be used in Brazil
, Britain, Canada
, China
, Czech Republic
, Hong Kong
, New Zealand
, Norway
, Slovak Republic, Spain
, and the United States
.
The surgical machine is supplied as CaverMap by Blue Torch Medical Technology, Inc.
A roughly equivalent procedure for women, vaginal photoplethysmograph
y, measures blood through the walls of the vagina
, which researchers claim increases during sexual arousal.
in then-Czechoslovakia
. Freund later wrote, "In the early fifties homosexual interaction was still an indictable offense in Czechoslovakia. I was of course opposed to this measure, but I still thought, as did my colleagues at the psychiatric university hospital in Prague where I was working, that homosexuality was an experientially acquired neurosis" (p. 223) He then developed phallometry to replace psychoanalytic
methods of assessment because "[P]sychoanalysis had turned out to be a failure, virtually unusable as an instrument for individual diagnosis or research....When phallometry began to look promising as a test of erotic sex and age preferences, we started using it mainly as a test of pedophilia, that is determining who has an erotic preference for children over adults" (p. 223-224).
In post-World-War-II Czechoslovakia, Freund was assigned by the communist government the task of identifying among military conscripts men who were falsely declaring themselves to be gay. "Freund (1957) developed the first device, which measured penile volume changes... to distinguish heterosexual and homosexual males for the Czechoslovakian army." When he escaped Europe for Canada, Freund was able to pursue his research using phallometry for the assessment of sexual offenders. At that time, attempts to develop methods of changing homosexual men into heterosexual men were being made by many sexologists, including John Bancroft, Albert Ellis, and William Masters of the Masters and Johnson
Institute. Because phallometry showed that such methods were failures, Freund was among the first sexologists to declare that such attempts were unethical.
(Fourth Edition) of the American Psychiatric Association
stated that penile plethysmography has been used in research settings to assess various paraphilias by measuring an individual's sexual arousal in response to visual and auditory stimuli. The reliability and validity of this procedure in clinical assessment have not been well established, and clinical experience suggests that subjects can simulate response by manipulating mental images."
In 1998, Hanson and Bussière published a comprehensive meta-analysis of 61 scientific reports on the prediction of sexual offenses spanning more than 40,000 individual cases. They ascertained that of all the methods attempted and reported, penile phethysmographic responses to imagery depicting children was the single most accurate predictor of future offenses. Another meta-analysis in 2005 of 73 studies repeated the finding that phallometric responses to children was a highly effective technique.
in urological polysomnography
centres. Lack of sexual response during REM sleep may indicate that further evaluation by a urologist is required.
When applied during nerve-sparing surgery, electrical stimulation penile plethysmograph is an erectile dysfunction prognostic. The patient is provided with objective information on his specific outcome which aids in planning for further erectile function therapies.
One study showed that homophobic men who have claimed to be heterosexual undergo arousal when given homosexual stimuli.
(a paraphilia
involving rape
) from groups of men without it.
, a scientific technique could not be used as evidence in court unless the technique was "generally accepted" as reliable in the relevant scientific community. This was known as the Frye standard
, adopted in 1923. In 1993, the doctrine was rejected by the Supreme Court of the United States
in favor of a more comprehensive "reliable foundation" test in Daubert v. Merrell Dow Pharmaceuticals
. In the Daubert standard
, the "generally accepted" test was no longer determinative. Several other factors could now be considered, including whether the technique had been published and peer reviewed. Myers notes, "Courts that have considered penile plethysmography generally rule that the technique is not sufficiently reliable for use in court."
In United States v. Powers the court excluded the penile plethysmograph test because it failed to qualify under Daubert's scientific validity prong for two reasons: the scientific literature does not regard the test as a valid diagnostic tool, and "a vast majority of incest offenders who do not admit their guilt, such as Powers, show a normal reaction to the test. The Government argues that such false negatives render the test unreliable."
According to Barker and Howell, penile plethysmography (PPG) does not meet the legal threshold for the guilt phase for the following reasons:
They concluded, "Until a way can be devised to detect and/or control false negatives and false positives, the validity of the test data will be questionable." Responding to Barker and Howell, Simon and Schouten noted, "Our own analysis suggests that the standardization and faking issues, as well as other problems not addressed in the Barker and Howell paper, warrant much more guarded conclusions about the use of the plethysmograph in legal and clinical settings." Prentky noted "the increased likelihood in forensic settings that dissimulation may compromise the validity of the assessment." Hall and Crowther noted penile plethysmography "may be even more problematic than other [methods] in assessing susceptibility of the test to faking."
In State of North Carolina v. Spencer, the court reviewed the literature and case law and concluded that penile plethysmography was scientifically unreliable: "Despite the sophistication of the current equipment technology, a question remains whether the information emitted is a valid and reliable means of assessing sexual preference."
More recently, a substantial amount of research data has been gathered and reviewed, and significant steps have been taken toward standardization. According to Launay (1999), "[T]he validity of the technique for research and clinical assessment is now established;" it is only the use in guilt-determination proceedings that is inappropriate. Fedoroff and Moran called it an "experimental procedure" and noted, "Virtually every expert who has written about phallometry has cautioned that it is insufficiently sensitive or specific to be used to determine the guilt or innocence of a person accused of a sex crime."
: "Courts have permitted plethysmographic testing for monitoring compliance by convicted sex offenders with the conditions of their community placement as part of crime-related treatment for sexual deviancy." Its use for the treatment and management of sexual offenders is recommended by the Association for the Treatment of Sexual Abusers. Becker notes it "should never be used exclusively in forensic decision making." The sexual assault
trial of basketball
player Kobe Bryant
in Colorado
brought this device and its use to public attention before the case was dropped in 2004, because Colorado law would have required evaluation with this device following conviction. The United States Court of Appeals for the Ninth Circuit
recently addressed the procedures required before a federal supervised release program could include penile plethysmograph testing. The device is routinely used at civil commitment facilities, but "some clinicians and offenders say it is easy, particularly in a laboratory, to stifle arousal and thus cheat on a plethysmograph test." This has been reported to occur in 16% of cases.
During the Catholic sex abuse cases, the reliability of the test was questioned by some officials in the Roman Catholic Archdiocese of Philadelphia. Later, these officials chose to seek therapy at an institution where the plethysmograph was not used.
came to a similar conclusion as those in the United States. The Supreme Court of Canada
adopted the Daubert doctrine
in R. v . J.-L.J. [2000] 2 S.C.R. 600, which upheld a lower court's decision to exclude testimony by a psychiatrist who had administered several tests on the accused, including a penile plethysmograph:
As of 2010, all youth in sex offender treatment programs administered by the Youth Forensic Psychiatric Service of British Columbia
were offered a voluntary penile plethysmograph test to predict whether they can properly control their deviant arousal, or whether they will require medication or other forms of treatment. According to sceptics, however, the test does not reliably predict recurrent violations.
writes, "More objectionable than the questionable scientific validity of the device, however, are the moral and legal questions its use raises." Carroll and others cite the legality of the depictions of minors, as well as the constitutionality of requiring PPG for admission to jobs or the military, or in custody cases. In Harrington v. Almy the United States Court of Appeals for the First Circuit
found that a PPG ordered to be administered by William O'Donohue
as a precondition of employment was a violation of plaintiff's rights under the Fourteenth Amendment to the United States Constitution
. In a 2009 report led by Robert Clift on use of the device on adolescent offenders, the authors acknowledge in their conclusions that PPG tests "are problematic ethically and should be used only after therapists have carefully weighed the benefits versus the negatives." The Minister of Children and Family Development closed the program examined in Clift's report in 2010 following complaints by civil rights groups. The principal manufacturer of the device stopped making them in the 1990s.
The EU's leading human rights agency, the Fundamental Rights Agency, has criticised the use of phallometric tests by the Czech Republic to determine whether asylum seekers presenting themselves as homosexual were in fact gay. According to the Agency, the Czech Republic was in 2010 the only EU country to employ a sexual arousal test, which the Agency said could violate the European Convention on Human Rights
. In 2011 the EU commission issued a statement calling the Czech practice illegal, saying "The practice of phallometric tests constitutes a strong interference with the person's private life and human dignity. This kind of degrading treatment should not be accepted in the European Union, nor elsewhere."
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
flow to the male genital
Human penis
The human penis is an external sexual organ of male humans. It is a reproductive, intromittent organ that additionally serves as the urinal duct.-Parts:...
. The most commonly reported methods of conducting penile plethysmography involve the measurement of the circumference of the penis with a mercury-in-rubber strain gauge, or the volume of the penis with an airtight cylinder and inflatable cuff at the base of the penis. Cavernous nerve penile plethysmographs measure changes in response to inter-operative electric stimulation during surgery. The volumetric procedure was invented by Kurt Freund
Kurt Freund
Kurt Freund was a Czech-Canadian physician and sexologist best known for developing phallometry , research studies in pedophilia, and for the "courtship disorder" hypothesis as a taxonomy of certain paraphilias Kurt Freund (17 January 1914–23 October 1996) was a Czech-Canadian physician and...
and is more accurate than is the circumferencial procedure which was developed soon afterward. The simpler circumferencial procedure is the more commonly used, however.
For sexual offenders it is typically used to determine the level of sexual arousal
Sexual arousal
Sexual arousal, or sexual excitement, is the arousal of sexual desire, during or in anticipation of sexual activity. Things that precipitate human sexual arousal are called erotic stimuli, or colloquially known as turn-ons. There are many potential stimuli, both physical or mental, which can cause...
as the subject is exposed to sexually suggestive content, such as pictures, movies or audio. Although there are individuals who have claimed that phallometry is not always appropriate for the evaluation of sexual preferences or treatment effects, large-scale meta-analytic review of the scientific reports demonstrated that phallometric response to stimuli depicting children is the single most accurate (with 32% accuracy) method of identifying which sexual offenders will go on to commit new sexual crimes.
For prostatectomy
Prostatectomy
A prostatectomy is the surgical removal of all or part of the prostate gland. Abnormalities of the prostate, such as a tumour, or if the gland itself becomes enlarged for any reason, can restrict the normal flow of urine along the urethra....
nerve-sparing surgery
Nerve-sparing surgery
Nerve-sparing surgery is a type of surgery that attempts to save the nerves near the tissues being removed.It is commonly applied in radical retropubic prostatectomy where surgeons may visually identify the cavernous nerves of penis or apply an electrical stimulation penile plethysmograph...
, the surgeon applies a mild electrical stimulation near the cavernous nerves of penis
Cavernous nerves of penis
The cavernous nerves are post-ganglionic parasympathetic nerves that facilitate penile erection. They arise from cell bodies in the inferior hypogastric plexus where they receive the pre-ganglionic pelvic splanchnic nerves ....
to verify their locations and avoid operative trauma. Damage to these difficult to see nerves can cause erectile dysfunction
Erectile dysfunction
Erectile dysfunction is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance....
outcomes. At the surgery's conclusion, the electrical stimulation penile plethysmograph result is a prognostic which helps to manage the erectile function outcomes earlier than the many months required for recovery.
Types
There are two types of penile plethysmograph:- Volumetric air chamber
- When this is placed over the subject's penis, as tumescenceTumescenceTumescence is the quality or state of being tumescent or swollen. Tumescence usually refers to the normal engorgement with blood of the erectile tissues, marking sexual excitation and possible readiness for sexual activity...
increases, the air displaced is measured.- Circumferential transducer
- This uses a mercury-in-rubber or indium/gallium-in-rubber ring strain gaugeStrain gaugeA strain gauge is a device used to measure the strain of an object. Invented by Edward E. Simmons and Arthur C. Ruge in 1938, the most common type of strain gauge consists of an insulating flexible backing which supports a metallic foil pattern. The gauge is attached to the object by a suitable...
and is placed around the shaft of the subject's penis to measure changes in circumference.
The circumferential type is more common, but the volumetric method is more accurate.
Significant suppliers of PPG machines include Behavioral Technology Inc. and Medical Monitoring Systems. The device is known to be used in Brazil
Brazil
Brazil , officially the Federative Republic of Brazil , is the largest country in South America. It is the world's fifth largest country, both by geographical area and by population with over 192 million people...
, Britain, Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
, China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...
, Czech Republic
Czech Republic
The Czech Republic is a landlocked country in Central Europe. The country is bordered by Poland to the northeast, Slovakia to the east, Austria to the south, and Germany to the west and northwest....
, Hong Kong
Hong Kong
Hong Kong is one of two Special Administrative Regions of the People's Republic of China , the other being Macau. A city-state situated on China's south coast and enclosed by the Pearl River Delta and South China Sea, it is renowned for its expansive skyline and deep natural harbour...
, New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
, Norway
Norway
Norway , officially the Kingdom of Norway, is a Nordic unitary constitutional monarchy whose territory comprises the western portion of the Scandinavian Peninsula, Jan Mayen, and the Arctic archipelago of Svalbard and Bouvet Island. Norway has a total area of and a population of about 4.9 million...
, Slovak Republic, Spain
Spain
Spain , officially the Kingdom of Spain languages]] under the European Charter for Regional or Minority Languages. In each of these, Spain's official name is as follows:;;;;;;), is a country and member state of the European Union located in southwestern Europe on the Iberian Peninsula...
, and the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
.
The surgical machine is supplied as CaverMap by Blue Torch Medical Technology, Inc.
A roughly equivalent procedure for women, vaginal photoplethysmograph
Vaginal photoplethysmograph
The Vaginal photoplethysmograph is a type of plethysmograph. It consists of a clear acrylic, rod-shaped device that contains a light source, and a light detector. The light source illuminates the capillary bed of the vaginal wall and the blood circulating within it...
y, measures blood through the walls of the vagina
Vagina
The vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...
, which researchers claim increases during sexual arousal.
Development
The original volumetric was developed during the 1950s by Kurt FreundKurt Freund
Kurt Freund was a Czech-Canadian physician and sexologist best known for developing phallometry , research studies in pedophilia, and for the "courtship disorder" hypothesis as a taxonomy of certain paraphilias Kurt Freund (17 January 1914–23 October 1996) was a Czech-Canadian physician and...
in then-Czechoslovakia
Czechoslovakia
Czechoslovakia or Czecho-Slovakia was a sovereign state in Central Europe which existed from October 1918, when it declared its independence from the Austro-Hungarian Empire, until 1992...
. Freund later wrote, "In the early fifties homosexual interaction was still an indictable offense in Czechoslovakia. I was of course opposed to this measure, but I still thought, as did my colleagues at the psychiatric university hospital in Prague where I was working, that homosexuality was an experientially acquired neurosis" (p. 223) He then developed phallometry to replace psychoanalytic
Psychoanalysis
Psychoanalysis is a psychological theory developed in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav...
methods of assessment because "[P]sychoanalysis had turned out to be a failure, virtually unusable as an instrument for individual diagnosis or research....When phallometry began to look promising as a test of erotic sex and age preferences, we started using it mainly as a test of pedophilia, that is determining who has an erotic preference for children over adults" (p. 223-224).
In post-World-War-II Czechoslovakia, Freund was assigned by the communist government the task of identifying among military conscripts men who were falsely declaring themselves to be gay. "Freund (1957) developed the first device, which measured penile volume changes... to distinguish heterosexual and homosexual males for the Czechoslovakian army." When he escaped Europe for Canada, Freund was able to pursue his research using phallometry for the assessment of sexual offenders. At that time, attempts to develop methods of changing homosexual men into heterosexual men were being made by many sexologists, including John Bancroft, Albert Ellis, and William Masters of the Masters and Johnson
Masters and Johnson
The Masters and Johnson research team, composed of William H. Masters and Virginia E. Johnson, pioneered research into the nature of human sexual response and the diagnosis and treatment of sexual disorders and dysfunctions from 1957 until the 1990s....
Institute. Because phallometry showed that such methods were failures, Freund was among the first sexologists to declare that such attempts were unethical.
Reliability and validity
In 1994, the Diagnostic and Statistical Manual of Mental DisordersDiagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
(Fourth Edition) of the American Psychiatric Association
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...
stated that penile plethysmography has been used in research settings to assess various paraphilias by measuring an individual's sexual arousal in response to visual and auditory stimuli. The reliability and validity of this procedure in clinical assessment have not been well established, and clinical experience suggests that subjects can simulate response by manipulating mental images."
In 1998, Hanson and Bussière published a comprehensive meta-analysis of 61 scientific reports on the prediction of sexual offenses spanning more than 40,000 individual cases. They ascertained that of all the methods attempted and reported, penile phethysmographic responses to imagery depicting children was the single most accurate predictor of future offenses. Another meta-analysis in 2005 of 73 studies repeated the finding that phallometric responses to children was a highly effective technique.
Erectile dysfunction
The penile plethysmograph has value in screening organic versus psychogenic erectile dysfunctionErectile dysfunction
Erectile dysfunction is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance....
in urological polysomnography
Polysomnography
Polysomnography , also known as a sleep study, is a multi-parametric test used in the study of sleep and as a diagnostic tool in sleep medicine. The test result is called a polysomnogram, also abbreviated PSG...
centres. Lack of sexual response during REM sleep may indicate that further evaluation by a urologist is required.
When applied during nerve-sparing surgery, electrical stimulation penile plethysmograph is an erectile dysfunction prognostic. The patient is provided with objective information on his specific outcome which aids in planning for further erectile function therapies.
Male homosexuality
Phallometry has been shown to distinguish gay men from straight men.One study showed that homophobic men who have claimed to be heterosexual undergo arousal when given homosexual stimuli.
Pedophilia and hebephilia
Studies examining the efficiency of using penile plethysmograph to distinguish between pedophilic men from non-pedophilic men show that a majority can be correctly assigned to the proper category. In one study, 21% of the subjects were excluded for various reasons, including "the subject's erotic age-preference was uncertain and his phallometrically diagnosed sex-preference was the same as his verbal claim" and attempts to influence the outcome of the test. In a second study, sensitivity of the method to distinguish between pedophilic men from non-pedophilic men was estimated between 29% and 61% depending on subgroup.Cross-dressing
Phallometry might distinguish men with erotic interests in cross-dressing from non-cross-dressers.Biastophilia
There is some evidence that phallometry can distinguish groups of men with biastophiliaBiastophilia
Biastophilia and its Latin language-derived counterpart, raptophilia , also paraphilic rape, refer to a paraphilia in which sexual arousal is dependent on, or is responsive to, the act of assaulting an unconsenting person, especially a stranger.Some dictionaries consider the terms synonymous,...
(a paraphilia
Paraphilia
Paraphilia is a biomedical term used to describe sexual arousal to objects, situations, or individuals that are not part of normative stimulation and that may cause distress or serious problems for the paraphiliac or persons associated with him or her...
involving rape
Rape
Rape is a type of sexual assault usually involving sexual intercourse, which is initiated by one or more persons against another person without that person's consent. The act may be carried out by physical force, coercion, abuse of authority or with a person who is incapable of valid consent. The...
) from groups of men without it.
Legal admissibility
In general, phallometric test results are employed as part of the sentencing and rehabilitation phase of forensic systems, but not for determining whether a specific defendant is guilty of any specific offense against any specific person.Use as trial evidence
In the United StatesUnited States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, a scientific technique could not be used as evidence in court unless the technique was "generally accepted" as reliable in the relevant scientific community. This was known as the Frye standard
Frye Standard
The Frye standard, Frye test, or general acceptance test is a test to determine the admissibility of scientific evidence. It provides that expert opinion based on a scientific technique is admissible only where the technique is generally accepted as reliable in the relevant scientific community. In...
, adopted in 1923. In 1993, the doctrine was rejected by the Supreme Court of the United States
Supreme Court of the United States
The Supreme Court of the United States is the highest court in the United States. It has ultimate appellate jurisdiction over all state and federal courts, and original jurisdiction over a small range of cases...
in favor of a more comprehensive "reliable foundation" test in Daubert v. Merrell Dow Pharmaceuticals
Daubert v. Merrell Dow Pharmaceuticals
Daubert v. Merrell Dow Pharmaceuticals, is a United States Supreme Court case determining the standard for admitting expert testimony in federal courts...
. In the Daubert standard
Daubert Standard
The Daubert standard is a rule of evidence regarding the admissibility of expert witnesses' testimony during United States federal legal proceedings. Pursuant to this standard, a party may raise a Daubert motion, which is a special case of motion in limine raised before or during trial to exclude...
, the "generally accepted" test was no longer determinative. Several other factors could now be considered, including whether the technique had been published and peer reviewed. Myers notes, "Courts that have considered penile plethysmography generally rule that the technique is not sufficiently reliable for use in court."
In United States v. Powers the court excluded the penile plethysmograph test because it failed to qualify under Daubert's scientific validity prong for two reasons: the scientific literature does not regard the test as a valid diagnostic tool, and "a vast majority of incest offenders who do not admit their guilt, such as Powers, show a normal reaction to the test. The Government argues that such false negatives render the test unreliable."
According to Barker and Howell, penile plethysmography (PPG) does not meet the legal threshold for the guilt phase for the following reasons:
- No standardization
- Test results are not sufficiently accurate
- Results are subject to faking and voluntary control by test subjects
- High incidence of false negatives and false positives
- Results are open to interpretation
They concluded, "Until a way can be devised to detect and/or control false negatives and false positives, the validity of the test data will be questionable." Responding to Barker and Howell, Simon and Schouten noted, "Our own analysis suggests that the standardization and faking issues, as well as other problems not addressed in the Barker and Howell paper, warrant much more guarded conclusions about the use of the plethysmograph in legal and clinical settings." Prentky noted "the increased likelihood in forensic settings that dissimulation may compromise the validity of the assessment." Hall and Crowther noted penile plethysmography "may be even more problematic than other [methods] in assessing susceptibility of the test to faking."
In State of North Carolina v. Spencer, the court reviewed the literature and case law and concluded that penile plethysmography was scientifically unreliable: "Despite the sophistication of the current equipment technology, a question remains whether the information emitted is a valid and reliable means of assessing sexual preference."
More recently, a substantial amount of research data has been gathered and reviewed, and significant steps have been taken toward standardization. According to Launay (1999), "[T]he validity of the technique for research and clinical assessment is now established;" it is only the use in guilt-determination proceedings that is inappropriate. Fedoroff and Moran called it an "experimental procedure" and noted, "Virtually every expert who has written about phallometry has cautioned that it is insufficiently sensitive or specific to be used to determine the guilt or innocence of a person accused of a sex crime."
Post-conviction use
Phallometry is widely considered appropriate for treatment and supervision of convicted sex offendersSex and the law
In general, laws proscribe acts which are considered either sexual abuse, or behavior that societies consider to be inappropriate and against the social norms. In addition, certain categories of activity may be considered crimes even if freely consented to...
: "Courts have permitted plethysmographic testing for monitoring compliance by convicted sex offenders with the conditions of their community placement as part of crime-related treatment for sexual deviancy." Its use for the treatment and management of sexual offenders is recommended by the Association for the Treatment of Sexual Abusers. Becker notes it "should never be used exclusively in forensic decision making." The sexual assault
Sexual assault
Sexual assault is an assault of a sexual nature on another person, or any sexual act committed without consent. Although sexual assaults most frequently are by a man on a woman, it may involve any combination of two or more men, women and children....
trial of basketball
Basketball
Basketball is a team sport in which two teams of five players try to score points by throwing or "shooting" a ball through the top of a basketball hoop while following a set of rules...
player Kobe Bryant
Kobe Bryant
Kobe Bean Bryant is an American professional basketball player who plays shooting guard for the Los Angeles Lakers of the National Basketball Association . Bryant enjoyed a successful high school basketball career at Lower Merion High School, where he was recognized as the top high school...
in Colorado
Colorado
Colorado is a U.S. state that encompasses much of the Rocky Mountains as well as the northeastern portion of the Colorado Plateau and the western edge of the Great Plains...
brought this device and its use to public attention before the case was dropped in 2004, because Colorado law would have required evaluation with this device following conviction. The United States Court of Appeals for the Ninth Circuit
United States Court of Appeals for the Ninth Circuit
The United States Court of Appeals for the Ninth Circuit is a U.S. federal court with appellate jurisdiction over the district courts in the following districts:* District of Alaska* District of Arizona...
recently addressed the procedures required before a federal supervised release program could include penile plethysmograph testing. The device is routinely used at civil commitment facilities, but "some clinicians and offenders say it is easy, particularly in a laboratory, to stifle arousal and thus cheat on a plethysmograph test." This has been reported to occur in 16% of cases.
During the Catholic sex abuse cases, the reliability of the test was questioned by some officials in the Roman Catholic Archdiocese of Philadelphia. Later, these officials chose to seek therapy at an institution where the plethysmograph was not used.
Canada
Courts in CanadaCanada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
came to a similar conclusion as those in the United States. The Supreme Court of Canada
Supreme Court of Canada
The Supreme Court of Canada is the highest court of Canada and is the final court of appeals in the Canadian justice system. The court grants permission to between 40 and 75 litigants each year to appeal decisions rendered by provincial, territorial and federal appellate courts, and its decisions...
adopted the Daubert doctrine
Daubert Standard
The Daubert standard is a rule of evidence regarding the admissibility of expert witnesses' testimony during United States federal legal proceedings. Pursuant to this standard, a party may raise a Daubert motion, which is a special case of motion in limine raised before or during trial to exclude...
in R. v . J.-L.J. [2000] 2 S.C.R. 600, which upheld a lower court's decision to exclude testimony by a psychiatrist who had administered several tests on the accused, including a penile plethysmograph:
As of 2010, all youth in sex offender treatment programs administered by the Youth Forensic Psychiatric Service of British Columbia
British Columbia
British Columbia is the westernmost of Canada's provinces and is known for its natural beauty, as reflected in its Latin motto, Splendor sine occasu . Its name was chosen by Queen Victoria in 1858...
were offered a voluntary penile plethysmograph test to predict whether they can properly control their deviant arousal, or whether they will require medication or other forms of treatment. According to sceptics, however, the test does not reliably predict recurrent violations.
Ethics and legality of use
Robert Todd CarrollRobert Todd Carroll
Robert Todd Carroll , Ph.D., is an American writer and academic. Carroll has written several books and skeptical essays but achieved notability by publishing the Skeptic's Dictionary online in 1994.-Early life and education:...
writes, "More objectionable than the questionable scientific validity of the device, however, are the moral and legal questions its use raises." Carroll and others cite the legality of the depictions of minors, as well as the constitutionality of requiring PPG for admission to jobs or the military, or in custody cases. In Harrington v. Almy the United States Court of Appeals for the First Circuit
United States Court of Appeals for the First Circuit
The United States Court of Appeals for the First Circuit is a federal court with appellate jurisdiction over the district courts in the following districts:* District of Maine* District of Massachusetts...
found that a PPG ordered to be administered by William O'Donohue
William O'Donohue
William T. "Bill" O'Donohue is an American psychologist who focuses on human sexuality, especially child sexual abuse. In 2009 O'Donohue was appointed as advisor to the DSM-V Work Group on Sexual and Gender Identity Disorders of the American Psychiatric Association.-Life and career:O'Donohue...
as a precondition of employment was a violation of plaintiff's rights under the Fourteenth Amendment to the United States Constitution
Fourteenth Amendment to the United States Constitution
The Fourteenth Amendment to the United States Constitution was adopted on July 9, 1868, as one of the Reconstruction Amendments.Its Citizenship Clause provides a broad definition of citizenship that overruled the Dred Scott v...
. In a 2009 report led by Robert Clift on use of the device on adolescent offenders, the authors acknowledge in their conclusions that PPG tests "are problematic ethically and should be used only after therapists have carefully weighed the benefits versus the negatives." The Minister of Children and Family Development closed the program examined in Clift's report in 2010 following complaints by civil rights groups. The principal manufacturer of the device stopped making them in the 1990s.
The EU's leading human rights agency, the Fundamental Rights Agency, has criticised the use of phallometric tests by the Czech Republic to determine whether asylum seekers presenting themselves as homosexual were in fact gay. According to the Agency, the Czech Republic was in 2010 the only EU country to employ a sexual arousal test, which the Agency said could violate the European Convention on Human Rights
European Convention on Human Rights
The Convention for the Protection of Human Rights and Fundamental Freedoms is an international treaty to protect human rights and fundamental freedoms in Europe. Drafted in 1950 by the then newly formed Council of Europe, the convention entered into force on 3 September 1953...
. In 2011 the EU commission issued a statement calling the Czech practice illegal, saying "The practice of phallometric tests constitutes a strong interference with the person's private life and human dignity. This kind of degrading treatment should not be accepted in the European Union, nor elsewhere."
External links
- Online version of penile plethysmography entry in Skeptic's Dictionary via Robert Todd CarrollRobert Todd CarrollRobert Todd Carroll , Ph.D., is an American writer and academic. Carroll has written several books and skeptical essays but achieved notability by publishing the Skeptic's Dictionary online in 1994.-Early life and education:...
- British Psychological Society's Guidelines for PPG
- Phallometry in Research and Clinical Diagnosis by Dr. Ray Blanchard