What about this? How do you feel about amputating totally healthy limbs because the person who owns those limbs feels as though they don't belong there? Does this make sense? Is this the right "route" to take in treatment of these people, to handicap them forever?
The science and ethics of voluntary amputation | Mo Costandi
The science and ethics of voluntary amputation
Should amputation be offered as a treatment to people suffering from Body Integrity Identity Disorder?
Mo Costandi
@mocost
Wed 30 May 2012 13.07 EDTFirst published on Wed 30 May 2012 13.07 EDT
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In Habib Azar's 2010 black comedy
Armless, Daniel London plays John, who has a compulsive desire to have both of his arms cut off
Earlier this month I gave a talk about a condition called Body Identity Integrity Disorder, which is characterised by the desire to amputate a healthy limb. I described the possible neurological basis of the condition, and then argued that surgical amputation should be offered to those sufferers who request it. Here's a summary of the talk.
In January 2000, the mass media ran several stories about
Robert Smith, a surgeon at the Falkirk and District Royal Infirmary who had
amputated the legs of two patients at their own request and was planning a third amputation. The news stories incorrectly described the patients as suffering from Body Dysmorphic Disorder. They further stated that the director of NHS trust running the hospital at which Smith works described the amputation of healthy limbs as "inappropriate"; since then, no British hospital has performed a voluntary amputation.
The patients were, in fact, suffering from Body Integrity Identity Disorder (BIID), an apparently rare condition characterized by a burning and incessant desire to amputate an otherwise perfectly healthy limb. The first documented case of BIID dates back to a medical textbook published in 1785, by the French surgeon and anatomist Jean-Joseph Sue, who described the case of an Englishman who fell in love with a one-legged woman, and wanted to become an amputee himself so that he could win her heart. He offered a surgeon 100 guineas to amputate his leg and, when the surgeon refused, forced him to perform the operation at gunpoint.
Subsequently, the pioneering neuropsychiatrist Richard von Krafft-Ebing described three cases of what appear to be BIID in his classic 1906 book,
Psycopathia Sexualis. "Even bodily defects become fetishes," wrote von Krafft-Ebing. He describes a 28-year-old factory engineer, who "complained of a peculiar mania, which caused him to doubt his sanity." He continues:
Since his 17th year he became sexually excited at the sight of physical defects in women, especially lameness and disfigured feet. Normal women had no attraction for him. If a woman, however, was afflicted with lameness or with contorted or disfigured feet, she exercised a powerful sensual influence over him, no matter whether she was otherwise pretty or ugly. In his dreams… the forms of halting women were ever before him. At times he could not resist the temptation to imitate their gait, which caused vehement orgasm with lustful ejaculation… He thought it would cause him intense pleasure to mate with a lame woman. At any rate, he could never marry any other than a lame woman.
This is followed by a second case:
He used to limp about the room on two brooms in lieu of crutches, or when unobserved, go limping about the streets… in his erotic dreams, the idea of the limping girl was always the controlling element. The personality of the halting girl was a matter of indifference, his interest being solely centered in the limping foot. He never had coitus with a girl thus afflicted. His perverse fancies revolved around masturbation against the foot of a halting female. At times he anchored his hope on the thought that he might succeed in winning and marrying a chaste lame girl… His present existence was on of untold misery.
Finally, Krafft-Ebing describes the case of a 30-year-old civil servant:
…since his 7th year he had for a playmate a lame girl of the same age. At the age of 12, puberty set in, and it lies beyond doubt that the first sexual emotions towards the other sex were coincident with the sight of the lame girl. For ever after only halting women excited him sexually. His fetish was a pretty lady who, like the companion of his childhood, limped with the left foot. He sought early relations with the opposite sex but was absolutely impotent with women who were not lame. Virility and gratification were most strongly elicited if the woman limped with the left foot, but he was also successful if the lameness was in the right foot. His sexual anomaly rendered him very unhappy and he was often near committing suicide.