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Mother’s Obesity Raises Risk of Birth Defects

Mothers Obesity Raises Risk of Birth Defects

The health risks of being obese are certainly well known by now — diabetes, heart disease, stroke and hypertension, to name a few. But the dangers are even greater for pregnant women and particularly for their developing babies. A new analysis, published Feb. 11 in the Journal of the American Medical Association, documents a wider than expected range of birth defects that are more likely to plague babies born to obese women.

Led by Katherine Stothard at Newcastle University in Great Britain, the researchers reviewed 18 earlier studies of maternal weight and congenital abnormalities. Compared with women who maintained the recommended body mass index of between 18.5 and 26, women who were obese — defined as having a BMI of 29 or greater — before pregnancy were more than twice as likely to have an infant with spina bifida, nearly twice as likely to have a baby with other neural-tube defects, and more vulnerable to giving birth to babies with heart problems, cleft palate or cleft lip, abnormal rectum or anus development, and hydrocephaly, a condition in which excess spinal fluid builds up in the brain. While the risk of birth defects in obese women has been known, “I wouldn’t have predicted the range of birth defects found to be increased when we looked at maternal obesity,” says Judith Rankin, an epidemiologist and one of the authors of the study.

Earlier studies, including surveys by the Centers for Disease Control and Prevention, had documented the greater risk of neural-tube defects and kidney problems in children of obese moms. But the new study serves as a warning to both doctors and patients that a mother-to-be’s extra pounds should be considered a more powerful and far-reaching risk factor during pregnancy. While there are no conclusive explanations yet, researchers have three theories about why maternal obesity may lead to congenital abnormalities. First, many obese women may also have undiagnosed diabetes, which can lead to abnormal development of a fetus. Second, these moms may be eating a diet that is not as nutritionally sound as that of normal-weight women; obese women are more likely to be missing key nutrients, like folic acid, that are needed to prevent birth defects such as neural-tube abnormalities. “Levels of these nutrients might be lower in these moms, or if they are taking supplements, they may not be at levels that are adequate,” says Dr. Sina Haeri, a fellow in maternal and fetal medicine at the University of North Carolina Chapel Hill, who authored a study on obesity in pregnant teens.

Finally, says Rankin, the issue may be one of screening: because ultrasound monitoring of obese patients is much more difficult than the monitoring of thinner women, it could lead to more missed cases of deformities like neural-tube defects. “We know that it is much harder to get good visibility of the fetus in scanning women who are obese, and more babies may be born with spina bifida and other abnormalities in these women,” says Rankin.

The study highlights the need for both doctors and patients to be aware of the added risk that maternal obesity places on the developing baby. Doctors should not only advise women who are planning a family to try to maintain their recommended weight, but also ensure that those who are already pregnant receive proper nutrition and thorough ultrasound screening. “It’s important to remember that these adverse effects only affect a low percentage of obese women,” says Rankin. “But there are certain things that could be put into place to protect women and their babies if they are thinking of having a family.”

Read “This Is Why You’re Fat.”

Read “What Ages Us Most It’s Called Life.”

Israel’s Election Dashes Hopes for Peace

Israels Election Dashes Hopes for Peace

Israel’s election on Tuesday ended in a near draw, with the two front runners — centrist Kadima Party leader Tzipi Livni and hawkish Likud chief Benjamin Netanyahu — each claiming victory. With nearly all votes counted, Livni’s party won 28 Knesset seats, and Netanyahu’s 27 seats, both falling well short of a majority in the 120-seat Knesset.

The result could be the worst possible outcome for Israel, guaranteeing weeks of political turmoil ahead and stalling any attempts by U.S. President Barack Obama’s Administration to restart Middle East peace talks. Whoever comes to power in Israel is likely to be tugged in different directions by combative coalition partners. In the past, smaller parties have held governments of both the right and the left hostage to their narrow, self-serving agendas.

As the single largest party, Kadima will try to approach President Shimon Peres next week for permission to form what Livni calls a “national unity government that would be founded on the large parties in Israel from both Kadima’s left and right.” It is a logical option. But Livni lacks support among the other parties. For starters, she needs to coax Netanyahu to join her. The two parties actually share many of the same policies and ideologies — Kadima broke away from Likud and drifted to the center — and, in theory, their combined strength could usher in a solid, center-right government. But the mutual antagonism of both leaders makes an accommodation all but impossible. Netanyahu, for example, refused to debate with Livni in public, and both rivals launched smear attacks against each other.

Netanyahu, a former Prime Minister, insists that he should be Israel’s next Premier, not Livni. He may be right. Political analysts say the Likud leader stands a far better chance of stitching together a right-wing coalition with small religious groups and Yisrael Beitenu, a nationalist, anti-Arab party that was the surprise in this election. At the last poll, in 2006, Yisrael Beitenu won just 11 seats. Yesterday it won 15, knocking the venerable Labor Party, which picked up 13 seats, into fourth place.

With Kadima and Likud both far short of a majority in the Knesset, Yisrael Beitenu’s controversial leader, Avigdor Lieberman, has emerged as a key power broker. Speaking to his party supporters at midnight as votes were being tallied, Lieberman indicated that his natural inclination is to side with Netanyahu. “We want a right-wing government,” he said flatly. Lieberman also took a swing at the outgoing Kadima-led government for entering into Egyptian-brokered cease-fire talks with Gaza’s Islamic militants, Hamas. “We will not have direct or indirect negotiations with Hamas nor a cease-fire,” he said, adding that he would join any government that had as its objective “the defeat of Hamas.”

Political commentators and pollsters say Israelis shifted back to the right out of dissatisfaction over the failure of peace talks with the Palestinians and a lingering sense that the Gaza war ended too soon, without crushing Hamas militants or ending their rocket fire into southern Israel.

The rightward tilt is a blow to President Obama’s hopes that a new Israeli government might be willing to make peace with the Palestinians and various Arab neighbors. Netanyahu and Lieberman are pushing for the expansion of Jewish settlements in the West Bank, which Palestinians say is a main obstacle to peace, and they are adamant that Israel should hang on to the Golan Heights, which was seized from Syria in the 1967 war. Netanyahu and Lieberman also say the army ought to return to Gaza and wipe out Hamas. During the campaign, Netanyahu said, “There will be no alternative but to bring down the regime of Hamas, a terrorist organization pledged to our destruction. Ultimately, Israel cannot tolerate an Iranian base right next to its cities.”

Livni’s bid to become Israel’s first female Premier since Golda Meir in the 1970s looks increasingly hopeless. Spurned by Netanyahu, she will turn left to Labor and other smaller parties — but the only way she can make the numbers add up to a 61-seat majority is if she entices Lieberman to join her. The drawback is that if she succeeds, Labor and the leftist parties will leave in disgust. The Arab parties, which have a total of 11 seats, are also unlikely to join a Livni-led coalition because they remain angry over the Gaza invasion. Israeli Arabs voted in big numbers after Lieberman insisted that all Israeli Arabs take a loyalty oath or else lose their citizenship. Jamal Zahalka, leader of the Arab party Balad, said Israel’s assault in Gaza also rallied voters. “The Zionist parties all supported what happened in Gaza, so Arab voters reacted by voting for us and not the Zionist parties.”

Whoever Peres picks to form a new government — and it will probably be Netanyahu — that person will have 42 days to glue together a coalition. Most likely, the bartering will drag on for weeks, with outgoing Prime Minister Ehud Olmert staying on as caretaker, probably until early April. Before the voting, Israelis said they wanted a strong leader. What they have instead is a prolonged period of political disarray.

— With reporting by Jamil Hamad / Bethlehem and Aaron J. Klein / Jerusalem

See pictures of 60 years of Israel.

See pictures of life under Hamas in Gaza.

Congress’s New Love Affair with Twitter, for Better or Worse

In today’s carefully stage-managed Washington, the last thing anyone expects from members of Congress is candor or spontaneity. So perhaps it’s not all that surprising that Representative Pete Hoekstra unwittingly triggered a maelstrom of criticism last weekend when he Twittered about his trip to Iraq. “Just landed in Baghdad,” the Michigan Republican typed on his BlackBerry, alerting the nearly 3,000 people who have signed up to follow him on the social-networking service of the trip that he and five others, including House minority leader John Boehner, had embarked on. Hoekstra, the top Republican on the House Intelligence Committee, took exception to the criticism from both the left and right that he had somehow jeopardized the security of those on the trip through his messages, or Tweets. “On this trip, nothing was classified as secret or top secret or anything like that,” Hoekstra told TIME. “A whole range of people know about the trip, people with no security clearances, including my wife.”

It’s a safe assumption that none of the estimated 6 million Twitterers know Hoekstra as well as his wife, or even know him at all in the real world. But that, of course, is the appeal of the micro-blogging service. Folks can update their followers on what they are doing, thinking, enjoying or avoiding, all in 140 characters or less. For Representatives used to having their messages and contacts heavily filtered, Twitter offers a real-time connection with constituents and the media, for better or worse.

Following President Barack Obama’s groundbreaking success in recruiting and organizing millions of supporters on Twitter and other social sites such as Facebook, Qik, YouTube and Flickr, a growing number of Representatives are tapping into domains that many previously reserved for their grandchildren. “The word Facebook is becoming like a drinking game in our conference,” says one senior GOP aide. “We encourage members to sign up, but also encourage them to allow their staff to help them navigate it. We want them to be careful before members begin writing on their constituents’ walls.”

Indeed, most of the 65 Twittering Representatives rely on their staffs to post links to press releases and notices of public events. “The feed is live now on http://dodd.senate.gov. The town hall will start shortly,” reads a typical Tweet on Senate Banking Committee chairman Chris Dodd’s Twitter page. But a few members like Hoekstra are braving uncharted territory, providing a unique window into the daily machinations of the nation’s power brokers and, in the process, establishing a new form of civic journalism. Read “Even Gen X Is aTwitter.”

GOP Governors: Split over Obama’s Stimulus Plan

GOP Governors: Split over Obamas Stimulus Plan

When President Barack Obama took his stimulus road show into Florida on Tuesday, Governor Charlie Crist was waiting, tapping his foot. Crist, a Republican, is actually six months ahead of Washington in the stimulus game: in August, in response to his state’s economic implosion, he launched Accelerate Florida, which is pouring out more than $28 billion in stored-up state funds for the kind of infrastructure and school-construction projects that are still being debated inside the Beltway.

At the time Crist announced Accelerate Florida, few if any fellow
Republicans seemed to condemn the idea. And that makes it all the more
curious to Crist and other moderate Republicans that now, when states’ budget crises are even worse, conservative Republican governors in states like Texas, Mississippi, Louisiana and Alaska are following GOP leaders on Capitol Hill in adamant opposition to Obama’s federal stimulus package.

“I see this package as a pragmatic, commonsense opportunity to move forward,” Crist, who appeared with Obama in economically beleaguered Fort Myers today to tout the stimulus, told TIME on Monday night. “I didn’t campaign for Obama, we don’t agree on everything, but he’s my President, and my job is to help Florida stay in the black.” Introducing Obama at the town-hall meeting, Crist said it was not just important “that we support this stimulus package” but that “we do it in a bipartisan way … It’s about rising above” partisanship.

Crist’s puzzlement at his colleagues’ opposition reflects a fundamental divide in his party. If the stimulus debate has solidified Republican ideology in Washington, it has further exposed the party’s fault lines at the state level — where many believe the GOP’s future direction will be decided after the electoral disaster of 2008. For Crist and other moderate, bipartisan governors like California’s Arnold Schwarzenegger and Vermont’s Jim Douglas, backing the $800 billion recovery bill taking shape in Congress isn’t just an act of economic self-interest; it also lets them showcase a less ideological conservatism that they insist voters want in the 21st century. For the camp that includes South Carolina’s Mark Sanford, chairman of the Republican Governors Association, and Texas’ Rick Perry, the legislation is a federal leviathan that lets them display faithfulness to the roots of the GOP as a Big Government slayer. “Rather than devote an unprecedented number of dollars to expanding government,” Perry said last week, “they should stimulate the economy with something that actually works: tax cuts.”

25 More Things I Didn’t Want to Know About You

25 More Things I Didnt Want to Know About You

Apparently I was wrong. Facebook users actually love reading 25 things about themselves. I never expected to receive so many e-mails defending a person’s right to read about how much his high school biology lab partner hates goat cheese.

According to its supporters, Facebook’s “25 Things” trend helps people understand each other, and the millions and millions of poorly punctuated revelations have united people in a way no mere chain letter ever could. How else to explain such outpourings of compassion as “I too have been injured by a ninja throwing star,” “Phlegm problems Ugh, tell me about it,” and “I am another straight man who listens to Jewel.”

It’s almost certainly a by-product of our blogging, Twittering, Flickr-photo-sharing culture that people are no longer fazed by long lists of strangers’ quirks and neuroses. So perhaps my initial take on the phenomenon was too judgmental. Maybe “25 Things About Me” is more interesting than it appears. I decided to read 25 more things and find out:

1. I used to buy Donald Trump’s toilet paper.

2. I almost stole someone’s cat last weekend.

3. I would do dirty, dirty things to Tina Fey.

4. I have always felt destined for greatness. So far, this has been a total bust.

5. My favorite activities when I was young were building forts that spanned the whole playroom, dancing to Michael Jackson and throwing my brother down the stairs.

6. I work “That’s What She Said” jokes into every conversation.

Why Geithner’s Rescue Plan Spooked the Markets

Why Geithners Rescue Plan Spooked the Markets

Timothy Geithner to America: We’re going big, aggressive and expensive.

On Tuesday, the Treasury Secretary laid out general plans to fix the nation’s ailing financial sector. He called the Bush Administration’s efforts “late and inadequate” and pledged to do better. But his own approach seems to be a mix of what his predecessor, Hank Paulson, tried in the past, along with some new efforts. What’s more, Geithner indicated that the plans he is proposing would cost more than the $350 billion remaining in government rescue funds that were approved by Congress in October.

“Fixing the problems of the nation’s financial sector will require a substantial and sustained commitment from government,” said Geithner

Despite Geithner’s earnest commitment to spend heavily on a fix, Wall Steet was disappointed by the lack of details that he shared on the new programs. The Dow Jones industrial average fell nearly 382 points on Tuesday, most of it after Geithner made his speech. Investors may have also been spooked by his hint that the Treasury might need more money to solve the banking sector’s problems.

“I want to make clear that I am not hear today to ask for more money,” Geithner told Senators later in the day during congressional testimony. But, he added, “this is going to be an expensive problem.” He also emphasized how “complicated” the banking crisis had become.

Geithner’s new proposals include setting up an aggregator, or “bad bank,” to provide financing to encourage investors to buy up the troubled loans that are now sitting on bank balance sheets and causing huge losses for financial institutions. Geithner said he hopes to eventually spur as much as $1 trillion in investments in mortgage bonds and other loans that borrowers have either already fallen behind their payments on or may soon fall behind on.

In addition, Geithner said the government plans to spend at least $50 billion on a comprehensive housing program that would include an effort to modify loans and keep people in their homes. Paulson was against a large-scale home-loan modification program, saying it could be very expensive.

But Geithner also said the Treasury will continue and even expand some programs that are already in place, including putting more money in the banks that need it. Another plan, he said, is to greatly expand a program to restart the securitization of consumer loans. That program was launched by Paulson in November, but more than three months later, it has yet to get off the ground. Geithner said his plan was for that program to backstop as much as $1 trillion in consumer, small-business and commercial-real-estate lending. Absent from Geithner’s plan was a proposal to suspend so-called mark-to-market accounting rules, which have forced banks to take large losses on their bad loans, some of which are still current. Some prominent market watchers, including former presidential candidate Steve Forbes, have been calling for a change.

How much this will all cost, or how successful it will be, is unclear, but a look at just the “bad bank” proposal suggests that Geithner will need more than $350 billion to pull off his plans. While Geithner offered few details, the idea behind the “bad bank” is to encourage private investors to buy up the troubled assets now sitting on the banks’ balance sheets. As those loans decrease in value, the banks’ earnings take a hit, endangering a number of very large financial firms, including Citigroup and Bank of America.

The reason banks haven’t been able to sell these bonds is because investors believe those assets, mostly residential mortgages or bonds tied to home loans, are worth far less than the banks believe them to be. In order to get sales going again, the government will have to close that gap.

It may do so by offering loan guarantees to investors, saying the government will protect against losses beyond a certain point. Or the government may loan money to investors at very low rates, thus lowering the investors’ costs and making them more likely to be willing to take a risk on a security based on questionable mortgage loans. And why so few details on this plan As Geithner said shortly afterward on Bloomberg, “This is very complicated to get right.”

But whatever the government does will cost money, big money. According to Markit, a research firm that tracks prices of hard-to-trade mortgage bonds, the highest rated bonds tied to subprime home loans recently traded around $0.35 on the dollar. Figuring out what banks think those bonds are worth is much harder. The firms don’t put a precise value on each security, just what they think their total bond and loan portfolio is worth. But a recent story in the New York Times looked at one bond backed by 9,000 risky mortgage loans and found that the bank holding the bond valued it at 97 cents. While this bond is not strictly comparable to Markit’s index, the message is clear — you could drive a truck through the gap between market prices and the banks’ hopeful prices on their riskiest mortgage bonds.

Using that comparison as an example, even if banks swallow half the spread between the two prices, and investors get financing to potentially take on the rest, Geithner’s “bad bank” could cost $300 billion or so to spur a $1 trillion investment in subprime mortgage loans and bonds, which is what banks are hoping to offload. That doesn’t leave a heck of a lot for the loan-modification program or any of his other plans.

“The aspiration is that government funds can get leveraged up by using private investment to solve our financial problems,” says Vincent Reinhart, a former top economist at the Federal Reserve and a resident scholar at the conservative-leaning think tank American Enterprise Institute. “But that entails the government absorbing at least some of the losses of private investors, and that is going to cost money. We probably won’t know how much for years to come.”

Obama’s Stimulus Address Shows His Power at the Pulpit

Obamas Stimulus Address Shows His Power at the Pulpit

In the final years of his second term, it was not unusual to
find George W. Bush’s motorcade routes lined with protesters chanting their
objections or spelling them out on handmade signs. On Monday, President
Barack Obama traveled to one of the most economically imperiled parts of the
country — Elkhart, Ind. — to find his route bordered by hundreds of waving
supporters.

It continues to be this way for Obama, despite a three-week run
in the White House that has seen tax scandals, a public admission of presidential missteps and a bitter, sometimes chaotic legislative battle over his $800 billion stimulus plan. The new President remains close to a national golden boy, even as he now oversees a U.S. economy in free fall, the likes of which has not been recorded since before World War II. After Obama was pilloried by pundits for losing control of the stimulus fight inside the Beltway, a Gallup poll conducted late last week found that twice as many Americans approved of Obama’s handling of the stimulus package than of his Republican congressional foes’ work on the issue.

Obama proved what a skilled communicator he is on the campaign trail. But with the presidential bully pulpit now at his disposal, his substantial ability to explain himself at a time of widespread disillusionment is the source of tremendous power. Obama chose Monday to come before the American people for his first prime-time address, a dour and downbeat press conference that he used to offer a blunt warning of the perils ahead.

On the economy, he spoke of his concern that the country, burdened by government debt, could descend into a “catastrophe” if no immediate action is taken by Congress. On the war in Afghanistan, he warned of a “big challenge” and an uncertain time line for a
withdrawal. He even bemoaned the revelation that slugger Alex Rodriguez had
used steroids. “It’s depressing news on top of what’s been a flurry of
depressing items when it comes to Major League Baseball,” he said.

Why Global Warming May Be Fueling Australia’s Fires

Why Global Warming May Be Fueling Australias Fires

The raging infernos that have left more than 160 people dead in southern Australia burned with such speed that they resembled less a wildfire than a massive aerial bombing. Many victims caught in the blazes had no time to escape; their houses disintegrated around them, and they burned to death. As firefighters battle the flames and police begin to investigate possible cases of arson around some of the fires, there will surely be debates over the wisdom of Australia’s standard policy of advising residents to either flee a fire early or stay in their homes and wait it out. John Brumby, the premier of the fire-hit Australian state of Victoria, told a local radio station on Monday that “people will want to review that … There is no question that there were people who did everything right, put in place their fire plan, and it [didn’t] matter — their house was just incinerated.”

Although the wildfires caught so many victims by surprise last weekend, there has been no shortage of distant early-warning signs. The 11th chapter of the second working group of the 2007 Intergovernmental Panel on Climate Change, for example, warned that fires in Australia were “virtually certain to increase in intensity and frequency” because of steadily warming temperatures over the next several decades. Research published in 2007 by the Australian government’s own Commonwealth Scientific and Industrial Research Organization reported that by 2020, there could be up to 65% more “extreme” fire-danger days compared with 1990, and that by 2050, under the most severe warming scenarios, there could be a 300% increase in such days. “[The fires] are a sobering reminder of the need for this nation and the whole world to act and put at a priority the need to tackle climate change,” Australian Green Party leader Bob Brown told the Sky News.

Bar Refaeli: Sports Illustrated Cover Model

It’s that time of year again. Started in 1964 as a way to fill a winter lull in sports coverage, the Sports Illustrated swimsuit issue has become one of the most eagerly anticipated magazine issues of the year. Sports Illustrated estimates that the franchise reaches some 66 million people, including 4 in 10 adult American men. As befits such a massive enterprise, the cover is a closely guarded secret; even the model featured on it isn’t informed until the last minute. TIME caught up with this year’s cover girl, Israeli model Bar Refaeli, just an hour after she found out.

How did they tell you that you were going to be on the cover
They just invited me to the agency and told me I had an audition. My agent got me into his office, and everyone was here, and a camera crew and posters of the cover. My first thought was just like, you know, Why is this here Why are you tricking me I was speechless for a few long minutes. Which doesn’t happen often.

Did you think they were going to choose you
You know, the competition is so big and all the girls are so amazing and all the photographers are so good — I’m sure each and every picture is just incredible. I knew I was probably in the running, but I had no idea. I’d heard that, but I don’t know. I don’t know yet. These Sports Illustrated people, they know how to hold a secret. Let’s wait and see.
Would you rather have the Sports Illustrated cover or be on the side of a plane
Oh, Sports Illustrated. That’s something that is there forever, you know It’s like a collector’s item. And the plane, they would take it off probably after a few days. But both are really cool.
So what are you doing next after this
I’m shooting a show for MTV; we’re starting right after all the parties for Sports Illustrated. And then I have work, work, work, work. The show is called House of Style. They used to do it before, and now they’re bringing it back. So it’s very exciting. The year hasn’t started yet and it’s already been the best I’ve ever had.

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The Unkindest Cut: A Czech Solution for Sex Offenders

A doctor makes an incision in a man’s scrotal sac and, deftly wielding his scalpel, quickly removes both testicles. In the Czech Republic, that simple operation is the punishment for male sex offenders. But to the Council of Europe, the region’s leading human-rights body, the procedure is “invasive, irreversible and mutilating.” In a report issued last week, the council called the punishment “degrading” and demanded it be scrapped immediately.

Over the past decade, at least 94 prisoners have undergone the treatment in the Czech Republic, the only country in Europe that continues to surgically castrate sex offenders. The Czech government insists the procedure is a medical issue, one that permanently reduces testosterone levels to lower an offender’s sexual urges. And officials say it is performed only at the request of the prisoners themselves.

But the Council of Europe — whose Committee for the Prevention of Torture investigated the Czech policy — says it can be described as medical intervention only if the genitalia are diseased or damaged. “Surgical castration is no longer a generally accepted medical intervention in the treatment of sex offenders,” the council’s report said.

The Czech law has a long pedigree. Castration as punishment dates back thousands of years and crosses all world cultures. The methods have evolved from brutal knife swipes that removed entire genitalia to chemical treatments. Drugs that lower the testosterone, dampen the sex drive and inhibit erections are now available in Great Britain, Sweden, Germany, Denmark and many American states, but prisoners must volunteer for the treatment before the drugs are administered.

Despite many studies of the effectiveness of castration — both surgical and chemical — the results are inconclusive. Some surveys suggest castration can dramatically reduce recidivism. One 1989 survey in Germany of 104 voluntary castrates showed a 75% drop in sexual interest, libido, erection and ejaculation. But measuring such changes is notoriously difficult and often depends on the subjective self-reports of sex offenders. A 1989 Psychological Bulletin study concluded that “the recidivism rate for treated offenders is not lower than that for untreated offenders; if anything, it tends to be higher.” Many other studies emphasize the mental nature of deviant sexual interests, which cannot be cured through surgery. Fred S. Berlin, associate professor of psychiatry at the Johns Hopkins University School of Medicine, argues that even if most sexual offenders cannot be cured, many can be successfully treated through counseling. “It depends on the availability of adequate community-based resources, in some instances following a period of residential care,” he says.

In its report, the Council of Europe also criticized the fact that the Czechs often use the punishment on first-time, nonviolent offenders, like exhibitionists. Another issue: the Czech penal system effectively forces many prisoners into accepting the procedure out of fear they will be jailed for life if they do not, according to the council. “Given the context in which the intervention is offered, it is questionable whether consent to the option of surgical castration will always be truly free and informed,” it said. Investigators found five cases of it being performed on legally incapacitated offenders who were not capable of making an informed decision. They found only two convicts who had spontaneously volunteered for castration.

Civil rights groups say any kind of castration, even if reversible, could take society down the road to eugenics. A 1985 U.S. Supreme Court ruling said that involuntary surgical castration constituted cruel and unusual punishment. David Fathi, head of Human Rights Watch’s U.S. program in Washington, says the Czech methods not only defy medical convention but also are an affront to civil liberties. “Any irreversible punishment is a fundamental violation of human rights. And any kind of mutilation is barbaric,” he says.

Fathi says rehabilitation of sex offenders is far more effective than castration. “There are no easy answers,” he says. “But castration does not work any more than cutting off hands treats kleptomania.”
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