Surgical castration of sex offenders, still practised by doctors in Germany, has been condemned as \"degrading\" in a human rights report. The European Committee for the Prevention of Torture (CPT) acknowledges that it is rarely used but questions its effectiveness and whether each patient\'s consent is freely obtained. The Czech Republic, where the operation is used slightly more frequently, is the only other EU state to continue with the procedure. Alleviating suffering In a response attached to the document, the German government insists the treatment is not a punishment but enables \"suffering tied to an abnormal sex drive to be cured or at least alleviated\". The CPT criticism is contained within a report on Germany\'s adherence to the European convention of human rights, which outlaws torture, inhuman or degrading treatment. One section explains that \"Germany is one of the very few countries in Europe, where orchiectomy [surgical castration] may be applied in the context of treating of sexual offenders\". Under a German law dating back to 1969, the offender must give his consent, be informed about the implications and side-effects of castration and be informed about other treatments. Patients must be over 25 and doctors must be sure that it will not lead to physical or psychologically adverse effects that are \"disproportionate to the aspired aim of the intervention\". In some cases, it requires \"approval of the guardianship court [applicable only when the person concerned is not able to give a valid consent]\", the report notes. Frequency of surgery \"Surgical castration appears to be quite rare, not only in Berlin but throughout Germany,\" it adds. During the last 10 years, the total number of surgical castrations of sexual offenders in Germany has been fewer than five per year. Nonetheless, the CPT, which is part of the Strasbourg-based Council of Europe, expresses its \"fundamental objections to the use of surgical castration as a means of treatment of sexual offenders\" on four grounds. It has irreversible physical effects and removes a person\'s ability to procreate. Surgical castration is not \"in conformity with recognised international standards\". Testosterone levels may not be reduced and the presumed reduction in re-offending rates \"are not based on sound scientific evaluation\". Consent may not always be free and informed. Patients or prisoners [may] \"acquiesce rather than consent\", believing it is the only way to avoid indefinite imprisonment. Legislation: Variations of practice In the 20th century in Europe, a number of countries passed legislation to use surgical castration as a treatment for sex offenders. Later, laws that enabled forced surgical castration were either amended to ban involuntary castration or completely repealed. Although castration laws in some countries — Denmark, Finland, Sweden and Germany — are still practised, the actual practice of surgical castration has been abandoned. The only exception is the Czech Republic where voluntary surgical castration is still practised. Voluntary chemical castration, on the other hand, is practised today in the UK, France, Belgium, Germany, the Czech Republic, Denmark, Sweden, Hungary and Italy. In 2009, a law on compulsory chemical castration was enacted in Poland, making it the only country in Europe to administer such treatment for certain sex offenders.