Should Doctors Amputate Healthy Limbs?

by The Center for Bioethics and Culture

If you want to see why Western culture is going badly off the rails, just read the drivel that passes for learned discourse in many of our professional journals. The most recent example is “Amputees by Choice: Body Integrity Identity Disorder and the Ethics of Amputation,” published in the current issue of the Journal of Applied Philosophy (Vol. 22, No 1, 2005).

The question posed by the authors, Tim Bayne and Neil Levy, both Australian philosophy professors, is whether physicians should be permitted to amputate a patient’s healthy limb because the patient is obsessed with becoming an amputee, an apparently newly discovered mental disorder that has been given the name “Body Integrity Identity Disorder” (BIID).

For people of common sense, the answer is obvious: NO! First, who but a severely mentally disturbed person would want a healthy leg, arm, hand, or foot cut off? Such people need treatment, not amputation. Second, physicians are duty bound to “do no harm,” that is, they should refuse to provide harmful medical services to patients-no matter how earnestly requested. (Thus, if I were convinced that my appendix was actually a cancerous tumor, that would not justify my doctor acquiescing to my request for an appendectomy.) Finally, once the limb is gone, it is gone for good. Acceding to a request to be mutilated would amount to abandoning the patient.

But according to Bayne and Levy, and a minority of other voices in bioethics and medicine, the need to respect personal autonomy is so near-absolute that it should even permit doctors to cut off the healthy limbs of “amputee wannabes.” After all, the authors write, “we allow individuals to mould their body to an idealized body type” in plastic surgery-a desire that is “more problematic than the desire for amputation” since cosmetic surgery “reinforces a very unfortunate emphasis on appearance over substance.” (Emphasis within the text.) Moreover, the authors claim in full post modernist mode, just because a limb is biologically healthy, does not mean that the leg is real. Indeed, they argue, “a limb that is not experienced as one’s own is not in fact one’s own.”

That this kind of article is published in a respectable philosophical journal tells us how very radical and pathologically non judgmental the bioethics movement is becoming. And lest you believe that such advocacy could never reach the clinical setting: Think again. Such surgeries have already been performed in the United Kingdom with no adverse professional consequence to the amputating physicians.

Even more worrying, the current trends in American jurisprudence could one day legalize amputation as treatment for BIID. For example, in 1999, the Montana Supreme Court invalidated a law that required abortions to be performed in hospitals. But rather than limit the decision to that issue, the 6-2 majority opinion in James H. Armstrong, M.D. v. The State of Montana, imposed a radical and audacious medical ethic on the people of Montana, ruling: “The Montana Constitution broadly guarantees each individual the right to make medical judgments affecting her or his bodily integrity and health in partnership with a chosen health care provider free from government interference.”

If indeed almost anything goes medically in Montana-so long as a patient wants it and a health care professional is willing to provide it-then it would seem that a physician could legally amputate a patient’s healthy limbs upon request to satisfy a neurotic BIID obsession.

Award winning author Wesley J. Smith is a senior fellow at the Discovery Institute and a special consultant for the Center for Bioethics and Culture Network.

Previous post:

Next post: