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  1. #1
    deplorable basketcase Tellenbach's Avatar
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    Default An Ethical Dilemma: What to do with BIIDs

    There's a fascinating section in this book I'm currently reading about a mental illness called "body integrity identity disorder" or BIID. People with BIID seek elective amputations of their limbs because they feel it's a foreign object and they go to great lengths to remove the limb. Some have used guns to shoot off a hand; some stick a leg in a woodchipper; others use dry ice to destroy the limb, forcing surgeons to remove it.

    "I feel that my legs don't belong to me and shouldn't be there." (from 'Falling into the Fire', Christine Montross)

    There is currently no medical treatment for this disease. The only relief comes when the limb is amputated. Without the amputation, the sufferer feels extreme discomfort. What should the physician do?

    I wouldn't want to pay for someone's elective surgery, especially something expensive like an amputation, but if the individual is aware of the consequences of such a request, then he should have the right to mutilate his body. What say you?
    Senator Rand Paul is alive because of modern medicine and because his attacker punches like a girl.

  2. #2
    reflecting pool Typh0n's Avatar
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    Well that must be pretty depressing to read about, lol.

    The purpose of medicine is to treat the illness.

    If you remove the limb at the person's request, you're not treating the illness. Im guessing there might be some way to treat this with cognitive therapy, though perhaps the illness is so rare that not much research yet been done into it.

    Perosnally, if I were a doctor, I would refuse them the surgery. Of course, theyre just gonna go to the next doctor and ask for the same thing, so it might not be enough, I might also have to convince the entire medical body of following my decision.

  3. #3
    deplorable basketcase Tellenbach's Avatar
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    ^ Right. Physicians are taught to do no harm so cutting off a healthy limb goes against their beliefs but there is no alternative, no solution to easing the suffering of these individuals. Once the limb is cut off, they are cured and no longer suffer from the discomfort.

    Research shows that it's probably some damage or dysfunction in the parietal region of the brain. When the "foreign" limb is tapped, you get no signal in the parietal lobe but there is a signal from other limbs.
    Senator Rand Paul is alive because of modern medicine and because his attacker punches like a girl.

  4. #4
    I could do things Hard's Avatar
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    This is a tough call. Honestly, if there is no other way for the individual to be releaved of psychological pain, then I think it should be permitted. Psychological pain is no joke (I've experience it many times), and can be just as bad as physical pain (and having experienced kidney stones, I know bad physical pain too). This clearly is a psychological disorder, and they need to be treated. So the whole "do no harm" thing is sort of moot. It's harmful either way to leave them or treat them.

    I think that after all possible forms of therapy, medication, etc. have been exausted and proven to not work, then it could be permitted. They'd need to do a full psychological evaluation to see if there are any other underlying problems, but if that checks out then they can go forward. I'd also imagine a legal waiver would have to be signed so the individuals working for the hospital could not be sued or similar if they have a change of heat. The limbs could also be donated to individual needing a transplant so it wouldn't be completely for naught.
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  5. #5
    deplorable basketcase Tellenbach's Avatar
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    Quote Originally Posted by Hard
    The limbs could also be donated to individual needing a transplant so it wouldn't be completely for naught.
    That's what I was thinking but I don't think limb transplants are done due to the compatibility (length of limb has to match the recipient) and the immune response.
    Senator Rand Paul is alive because of modern medicine and because his attacker punches like a girl.

  6. #6
    I could do things Hard's Avatar
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    Quote Originally Posted by Tellenbach View Post
    That's what I was thinking but I don't think limb transplants are done due to the compatibility (length of limb has to match the recipient) and the immune response.
    They've been done, it's just very rare due to the genetic requirements, size requirements, timing requirements, etc. in order for it to work, as you stated.
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  7. #7
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    as long as the expense falls onto them..

  8. #8
    & Badger, Ratty and Toad Mole's Avatar
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    The problem is not the limb, it is the perception of the limb.

    So it is not the limb that needs to be cut off, but the perception.

    The limb is healthy but the perception is not.

  9. #9
    Honor Thy Inferior Such Irony's Avatar
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    Quote Originally Posted by Mole View Post
    The problem is not the limb, it is the perception of the limb.

    So it is not the limb that needs to be cut off, but the perception.

    The limb is healthy but the perception is not.
    But what if the perception can't be cured by conventional means (psychotherapy, medications, etc.) What if the only means of providing comfort is to amputate the limb. Then by all means I say do it. The limb is not required to live.

    Also, I wonder if an artificial limb is inserted in its place. Would the person with BIID also react to it in the same way?
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  10. #10
    & Badger, Ratty and Toad Mole's Avatar
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    Quote Originally Posted by Such Irony View Post
    But what if the perception can't be cured by conventional means (psychotherapy, medications, etc.) What if the only means of providing comfort is to amputate the limb. Then by all means I say do it. The limb is not required to live.

    Also, I wonder if an artificial limb is inserted in its place. Would the person with BIID also react to it in the same way?
    It's mutilation, not cure.

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