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364 Lancet, Dec. 2004, at 50


This article discusses the role of psychiatrists in determining the treatment of sexually violent predators (SVP). Instead of being released at the end of their prison sentences, sex offenders in the USA who are judged mentally disordered and dangerous are being confined in secure "treatment facilities" for indeterminate terms. This novel and aggressive legislative tactic—embodied in US sexually violent predator laws—commandeers the traditional power of state mental health systems and puts it in service to a core function of the criminal justice system: the control of sexual violence. This transposition of "civil commitment" has forced psychiatry to legitimate and arbitrate the boundaries of an aggressive and highly contested form of state coercion. By their very structure, SVP laws politicize psychiatry in ways that go well beyond the traditional interconnection between psychiatry and law.