Monday, July 04, 2005

The Ethics Of Amputating Healthy Limbs

“Two Australian philosophers believe surgeons should be allowed to cut off the healthy limbs of some "amputee wannabes". Neil Levy and Tim Bayne argue that patients obsessed with having a limb amputated should be able to have it safely removed by a surgeon, as long as they are deemed sane. "As long as no other effective treatment for their disorder is available, surgeons ought to be allowed to accede to their requests," the pair wrote in the Journal of Applied Philosophy.” – The Age.

The question that this position presents, is whether or not the philosophers are on the right track?

[Is it just me, or is The Age more philosophically inclined than The Sydney Morning Herald?]


Samuel Douglas said...

Tricky. Does wanting a healthy limb removed render one, by definition insane, and thus unable to give consent?
Apparently not.

Cooly McCool said...

What if the limb was healthy but utterly evil. Then you would be sane in having it removed. I've seen evil dead. I know limbs can be pure evil!

I'm assuming that by 'healthy' it is meant not necessitating amputation, and what is being argued for isn't simply amputation for cosmetic reasons. Clarifying some of this might help.

Richard Walston said...

These people need a psychiatrist not someone to allow them to cut off their own limbs. All my patients are destroyed over the loss of a limb. I handle Diabetic patients who have had a leg amputated for peripheral vascular disease. Sometimes they lose both LEGS! How horrible and these people want to voluntarily lost both legs. THIS IS RIDICULOUS. THEY need a psych evaluation.

Samuel Douglas said...

I agree. It makes little sense to talk of someone being 'sane' other than that desire to have a limb removed. As many of you know I facy myself as a bit of a libertarian, but this is a bit much even for me.
On the other hand, if they can pay for it, why not? What the Maarket wants the Market shall have, one way or the other.

Pete said...

I think the important phrase in Martin's original post is "as long as they are deemed sane." As with patients who request sex reassignment surgery, I expect that amputee wannabes would have to spend an enourmous amount of time in clinics, being assessed by health proffesionals, be able to show that they have a long history of identifying as an amputee, being educated as to the real (in this case overwhelmingly real) physical consequences and possible psychological consequences of the procedure, etc. If they go through all that and pass the tests then I can't see why they shouldn't be allowed to go through with it.

I can't see why they would want to go through with it in the first place either, but then again it was only after reading a lot of case studies and other related information about sex reassignment that I came to an understanding of why anyone would want to go through with that. And even then I still maintain very strong doubts that I "really" understand why they want to do it. Afterall, sex reassignment and amputation aren't things that I would consider going through myself so I can hardly claim to have a flawless understanding of these people's motives.

But another question that occurs to the republican in me is this: What is it that would make these people want to go through with this kind of thing in the first place? Surely a long history of people wanting to have limbs cut off would be hard to find, so why are we noticing that there are people who want to go through this type of thing now?

MH said...

As I understand it, and I have read little on this area of psychology (so I am open for criticism from those who know better), there are two different drives that lead individuals to desire to become disabled. The first is that they come to identify more with disabled individuals than with the able-bodied, and want to become disabled. The other drive, and they need not be connected, is that an individual may come to identify the limb as the cause of all their problems. That is, they begin to think 'x has gone wrong, and it is the fault of my arm; if I did not have the arm x would not have gone wrong'.

I agree with Mr Walston that these people need a psychiatrist; but can conceed that this cosmetic proceedure is no more insane than wanting to have your nose reshaped, your breasts reduced, or the fat around your waist extracted. It is unfortunate, as I understand it, that the drives that underlie this desire are not yet fully understood, and there is no treatment for the disorder.

I, like Mr Woodward, am interested as to the history of the disorder.

Pete said...

I feel a mix of being strangely disturbed by and yet dutifully compelled to ask this question:

Are you sure we should be labelling this thing a disorder yet Martin?

MH said...

Peter, I am not sure that this thing should be considered a disorder; it is just that 'disorder' seemed slightly more apropos than 'thing'. Once I get a chance to read the actual paper - am a bit busy at the moment, with the thesis and the green wig - I will try to clarify a couple of these issues. (Or, someone else could track down a copy and read it ...)