Yours Truly Taken To Task For Allegedly Inaccurate Article
I have heard from one of the authors of the journal article supporting the right of doctors to amputate healthy limbs for sufferers of a new mental health disorder known as Bodily Integrity Identity Disorder (BIID). He is unhappy with me. Neil Levy claims I misrepresented his and co-author Tim Bayne's work in an article I wrote for the Center for Bioethics and Culture. (Here is the link to my original article.)
Levy wrote: "You write that we advocate 'abandoning the patient' by acceding to their request to amputate a healthy limb. First, as you fail to mention, we conclude that the question is difficult, but we think that 'in some cases' it 'might' be acceptable to accede. Second, you misprepresent our views by taking them out of context. You say that we write, '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." If we had implied anything such thing, we would deserve your mockery. But it should be clear, from even a cursory reading, that we intended to claim not that if the patient believes the limb is not theirs it is not. We couldn't be claiming any such thing, because we distinguish between somatoparaphrenia, which is a delusion in which the patient denies ownership of the limb, and BIID, in which there are no false beliefs. The claim, rather, is that acknowledging ownership is normally a necesary condition for full ownership. Think of disowning a child. This is an act which does not alter the biological relationship, but alters the lived relationship. There is nothing 'postmodernist' about this. If you were familiar with norms in analytic philosophy you would hesitate to make such an accusation: no one is more vocal in denouncing facile relativism about truth.
Third, we do not advocate abandoning the patient. Once again, a careful reading of the article would indicate that amputation is recommended only as a last resort: so long as there is genuine and significant suffering and there is no alternative treatment that is effective. If there is such an affective treatment developed, than it is obviously preferable."
My response was as follows:
"Thank you for writing.
It was a 550 word opinion piece. It is very clear that the term abandonment was mine and not yours, as was the opinion and interpretation that cutting off a healthy limb would be an act of abandonment. I never claimed you believed in abandoning a patient.
I quoted you accurately about the healthy limb not being the patient's, an amazing statement in my view. Whether or not a patients "owns" the limb, does not make it any less real. And the point I was making is that autonomy is getting recklessly out of control in bioethics advocacy, and in jurisprudence as well, ergo the quoting of the Montana court case. I probably should have said that "as a last resort," you would permit amputation. But you would still allow amputation.
I certainly had no intention of misrepresenting your article. I don't believe I did. I believe the essence of what I wrote is true."
(I would also note that the abstract of the article, which the authors wrote, states that they argue, "BIID suffers meet reasonable standards for rationality and autonomy: so as long as no other effective treatment for their disorder is available, surgeons ought to be allowed to accede to their requests," in other words, cut off healthy limbs.)
Anyone interested in investigating this matter more fully, the cite is Journal of Applied Philosphy, Vol.22, No. 1, 2005.:
posted by Wesley J. Smith @ 8:51 AM
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For those who don’t want to run to the library or punish themselves by a subscription to a postmodernist academic rag, here’s a link I googled -- http://www.blackwell-synergy.com/toc/japp/22/1 -- it has just the abstracts for each article – which is enough to confirm the flavor of present “professional” philosopher’s understanding of morality.
Actually, though, their clarification that BIID is analogous to ‘disowning’ a family member is intriguing more than anything I saw in the abstract. Disowning a son is an act of emotional crippling. You cripple yourself and your interaction with a person that should be a “loved one”, yet the person still lives and functions normally except in the mutual emotional response. You seek to have other family and friends validate this “disowning” and certainly engage an attorney to formalize and assure cutoff of support to the disowned.
Therefore similarly when you have internalized some sort of emotional or mental illness to the disassociation of “yourself” from a certain body part, you should also have the right to physically cutoff support to same. However, one might note the difference that an adult cutoff from emotional and financial support (or possibility of inheritance) would survive though at some cost. I think it is as you say, an act of abandonment, as cutting off a limb would be like “disowning” an infant, an act of gross child abuse. So rationalization of such as “autonomy” makes sense of a continuum of acts of abandonment : expelling of unwanted but healthy “tissue” as abortion, abandonment of grossly defective others (euthanasia), or the totality of yourself by intentional act of your will (suicide). And yet this only the “dark side” of a philosophy of autonomy, if you can call narcissism, pleasure-seeking and hubris the “bright side”
Actually, what is notable in this blog, is that those opposing Mr. Smith's views accuse him of being uncharitable, mischaracterization, etc. AND THEN they stop. I have seen very little positive argument on what is good about animal liberation, what is the justifications of transhumanism or cloning research, let alone discussing or setting forth middle ground position of what are the moral limits of human behavior and defining humanity itself.
To my caustic critic: The authors' view that doctors should be permitted to amputate healthy limbs is not taken out of context, other than my ommission of their hedge "as a last resort." Indeed, their own abstract explicitly states that they advocate the potentiality of removing healthy limbs as an acceptable treatment for BIID. Moreover, the publication of this proposal in a very reputable professional journal tells us a tremendous amount about the general direction that bioethics discourse is taking and its general embrace of radical autonomy.
This is not just talk and idle musing. It is through such articles and discourse that public policy often gets changed. For example, in the 1980s bioethicists were debating whether it would be accaptable to remove fooding tubes from "biologically tenacious" (as one famous bioethicist put it)patients. Today, Terri Schiavo is dead from intentional dehydration.
I never intentionally mislead or distort. I do interpret and analyze, often in blunt language. That is often what angers bioethicists and others who embrace ideas and policies that undermine universal human equality and the sanctity of human life, but sometimes mask the impact such ideas would have by using passive language or inserting meaningless hedges.
You might be interested to know that I posted the criticism of me precisely so I could be fair. Indeed, the author was very appreciative, complimemnted my "fair play," and he and I have had an interesting private exchange on the issue.
Well said.
Now as to these troops that you are said to rally?
I don't think he quite gets it.
Dr. Dobson can rally troops, as the Inquirer puts it, but your combination of being Ralph Nader's buddy but postulating moral absolutes leaves both right and left scratching their heads.
Inquirer -
I think I (and Mr. Smith) probably was using postmodernist as shorthand for moral relativism and deconstructionism both of which may be seen in these types of philosophical essays.
Wesley Smith claims the authors " in full post modernist mode, just because a limb is healthy does not mean the leg is real". Though apparently they step back from the truly audacious statement that a "your leg is not your leg". Obviously biology is a mighty metanarrative to overcome. Your leg is not just a textual concept, it is a living part of you, at least until you cut it off. But they still claim you can disclaim ownership, I suppose since that is conceptual and relative.
I then wrote that even accepting those terms, 'disowning' is abandonment and can be construed in the continuum of acts justified in the name of "autonomy" some of which are still illegal and many of which are contemptible in the eyes of those who hold philosophies or beliefs that include moral absolutes.
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