This is an interesting question. A few years back I would have voted for medical treatment when necessary, but then I had the honor of meeting a very intelligent psychiatrist, who owned and ran his own mental hospital. A very interesting man.
Anyway, current events at the time included a vote on the Florida death penalty, so when the talk swung around to that, he surprised me by saying that he favored it tremendously. He explained (my memory’s a bit hazy on the terminology) that from what he’d seen, career criminals had “holes” in their psyche, specifically, in their ego (if I remember correctly). The id flew directly to the surface, so there was nothing stopping the instincts from their birth to their execution.
The gist of it was: that the rest of us have, to differing degrees of “thickness”, a layer of conscious and semi-conscious thought that stops animal impulses from being carried out, and these people simply didn’t. They did anything they wanted to, and he’d seen this in children as young as 6, sometimes with no reason at all. No history of family violence, no drugs, and sometimes these kids were going to be criminals, he knew it, and there was nothing that he could do.
But I digress. The conclusion was (and this from a man who ran his own privately owned psychiatric hospital): that there was nothing he or anyone else could ever do to help these patients. Ever. They were going to kill and rape and maim, at home, in jail, in the hospitals. They were, for all psychiatric purposes, very similar to animals in emotional and impulse control, and that’s why he favored the death penalty.
I don’t know how right or wrong he was, and this is the only medical opinion on the subject that I’ve ever gotten, but I thought I’d throw it out there. I still favor medical treatment, but now I’m not so sure about how much it can help. We could lock them up in mental hospital forever, and that would keep them off the streets, and I suppose that’s as good a solution as any.
