What We Are Becoming: More Support for Removing Healthy Limbs of "Amputee Wannabes"
There is a terrible mental illness called Body Integrity Identity Disorder (BIID), aka "amputee wannabe" because the sufferer becomes obsessed with having healthy limbs cut off. I have written before that some are actually arguing that a proper treatment for the disorder would be to cut off the healthy limb as requested. And now, an article in Neuroethics, urges this very course. From the article by Christopher James Ryan, Department of Psychiatry, University of Sydney, Australia:
When faced with a patient requesting the amputation of a healthy limb, clinicians should make a careful diagnostic assessment. If the patient is found to have body integrity identity disorder, amputation of the healthy limb may be appropriate after a trial of selective serotonin reuptake inhibitors and after careful consideration of the risks, benefits and unknowns of all possible treatment alternatives. The results of treatment trials should be published to allow growth in our knowledge of the condition.This too is an aspect of the culture of death and nihilism. And as is becoming increasingly common in these matters, doctors who have a moral problem, Dr. Ryan suggests, can opt out but must be complicit in the deed by finding a doctor willing to do the sawing:
Sufferers of BIID might be relieved to know that members of the medical profession will take their concerns seriously and that, after careful deliberation, elective amputation of their troubling limb is a real possibility.
As is the case in termination of pregnancy, dissenting doctors should be under no obligation to proceed with an amputation in these circumstances, but are under an obligation to refer the patient to another doctor whom they believe might proceed with the amputation if all the caveats are metSo, this is what we are becoming. In the name of autonomy, in the face of obsession and profound mental illness, learned professionals are arguing very seriously that physicians should be allowed to cut off healthy limbs. But such a course would not only harm the individual--harm properly understood--but it would be devastating blow to society, reflecting a culture that would willingly abandon the most disturbed among us to their psychoses and emotional demons. But expect me to be called uncompassionate for saying so.
Labels: What We Are Becoming. BIID.
posted by Wesley J. Smith @ 6:59 PM
46 Comments
46 Comments:
Dear Mr. Smith,
What the f*ck do you expect those of us with BIID to do?
I've heard it so often, "Sean, you're sick, you need help". I don't disagree with that. But after over 20 years of psychotherapy and pharmacotherapy of all ilks, I still suffer the intense demons of BIID. In fact, it's getting worse. 6 months ago, a noted psychiatrist told me that "there is nothing more mental health professionals can do for you". A month ago a different psychiatrist told me "try Zen Buddhism" (which, as a matter of fact, I have investigated a long time ago, to no avail).
I'm *much* more disabled by BIID than I ever would be as a paraplegic man. And I am well informed about the problems related to paraplegia.
Is it not better for a surgeon to assist me acquire the impairment I need than to have me attempt self-injury and cause more damage, or kill myself outright?
What is so negative about amputations or paraplegia that people react so negatively about it? What do you say to people who tell you "I'd rather be dead than disabled?" Do you agree with them? If so, perhaps your perception of disability skews your perception of BIID. If not, is it not hypoctrical to tell one person that disability is ok, but refuse another one the only known solution that could help them?
I wouldn't call you uncompassionate. But I would suggest you are perhaps wearing blinders that narrow your vision.
sean: I am sorry you have such a grievous condition. But I don't expect a doctor to cut off your limb. That would not only be bad for you and your health--although I realize your condition makes that difficult to accept--it would be bad for society.
There is nothing wrong with people who have amputations or who are or become paraplegic--of course! And if you read my posts, you will see that I urge help for those who say it is better to be dead than disabled, help to get them past the darkness.
But to permit physicians to accede to a desire to do oneself tremendous harm is a different matter.
Look at it this way: We know of people who are intent on burning themselves with cigarettes or cutting themselves. They do so because it eases their existential pain. Should we say, well let's have a doctor do it for you instead? At least in that way you won't get an infection?
I can't imagine how awful it is to be obsessed with losing a limb or limbs. I jope that one day they discover why such obsessions arise. My understanding is that this is a relatively new condition. There must be a discoverable cause. And once it is discovered, there is a step to treatment.
I am so sorry you are experiencing such agony.
And I appreciate very much your taking the time to write and sharing how things look from the trenches of this awful condition.
How would it be bad for society? Loss of a productive member of society? Considering the number of days of work I have lost due to BIID, and the numbers of jobs I have lost due to BIID-related depression, I assure you that would be much more productive for society were I actually paralysed.
And while there is discrimination in employment against people with disabilities, the fact that I've been employed for the 12+ years I've lived as a full time wheelchair user tells me that working as a paraplegic would not be a problem either.
Ok, so perhaps "bad for society" would mean the "high cost of treatment". Considering that I have paid for all my wheelchairs to date (at about $2,500 each), I don't see why I couldn't continue to pay for my own equipment. Also, considering the high cost of therapy and medication I've had to pay over the last 20 years, I really don't see the difference between society helping defray treatment cost for me as a paraplegic, or for me as someone suffering tremendously with the hell that is BIID. And if long term effects of paralysis mean I need further treatments, then would it not be an after effect of a mental condition I have no desire for (I never wanted this), nor have any control over?
The difference between people who repeatedly self-harm and BIID is that we are looking at modifying our body, once. It is not a case of "oh, I want an amputation", then later "oh, I want the other leg off", then later again "might be fun to be a triple amputee".
It is not such a new condition. First mentions of cases that look suspiciously like BIID are mentionned in medical books dating back to the late 1700's... And yes, you're right, there might be a discoverable cause. Just like there was a discoverable cause for Gender Identity Disorder. The "treatment" for that is, in most cases, Sex Reassignment Surgery. Not everything has a cure, unfortunately.
And while there might be a "cure" for BIID, the time it is likely to take to find it, as it is such a little known condition and there is no research money for it, that time is too long. Too long for me, and for dozens of people I know and am in regular contact with. I'm 40 years old. I have lived with this pain for more than 35 years. Just like the best metal alloy, I am resilient, but even the best alloy suffers from metal fatigue and eventually break. I am at breaking point.
I ask you - do you refuse me the ONLY known method to achieve peace and become a productive member of society, knowing that the only alternative for me is to drive my car off a bridge? Because that's where I'm at.
What is wrong with losing a limb, aside from such a condition being forced on you against your will?
I have to side with the BID sufferers on this one. This is a well-documented condition that is treatment-resistant. The current theory is that something goes wrong in-utero when the connections are being made between the brain and the body -- correct me if I'm wrong, folks with BID!
There needs to be a LOT of supervision of such decisions, to ensure that we don't end up with quack doctors who want to make a quick buck doing amputations on people who would respond to other treatment. And we'd need to take care that this supervision doesn't turn into the kind of rubber-stamping we see with "health" abortions.
But the person having the amputation is, unlike the aborter, making a decision purely about his or her own body. Unlike the person requesting assisted suicide, he or she will not die from the requested procedure. This is a case of how we provide medical care to people with a baffling, disturbing, horrific condition. And we need to proceed with compassion and due caution.
OOPS! That's BIID, not BID. Sorry.
I despise the culture of death. I am ardently, passionately pro-life. I've prayed outside of abortion clinics. I've cast my vote based on one issue alone. I also have BIID.
GrannyGrump is correct that the most recent research on BIID (conducted by the noted behavioral neurologist VS Ramachandran and his team at the Center for Brain and Cognition at the University of California San Diego) shows compelling evidence that BIID is neurological in origin - a congenital defect in the part of the brain that processes body image. The sufferer's brain is unable to properly process the presence of the limbs, and so lives in a constant hell where their body feels wrong and alien to them.
I agree that ultimately, repairing the neurocircuitry of the brain is the best way to cure BIID. But we are not there yet, we're a long way from that. Until we get there, it is wrong, and utterly lacking in compassion to allow those with BIID to continue to suffer while there is a simple known cure at hand! Yes, it is known that surgery does indeed cure the condition and that once the offending limb is removed, the person feels at peace, is free from the obsession and doesn't seek further amputation other than the limb that has always felt superfluous. A few have had this done by surgeons, others have taken the matter into their own hands, but unanimously they are cured.
Sean is right that BIID is a huge drain on the individual's productivity. I know any number of healthy, productive people with physical disabilities who enjoy better mental health than I do currently, and aren't a drain on society, but rather are a valuable contributor to it.
I do suspect that the current bias against surgery for BIID sufferers is based largely on prejudice against people with disabilities and the belief that they can't be happy, well-adjusted members of society.
You would have it that the culture of life prefers that someone suffer in mental agony rather than live as a happy, productive person who just happens to have a physical disability. Somehow, that doesn't seem very "culture of life" to me at all.
Life does not get easier for folks as the aging process moves forward and limbs start to fail. How sad that folks miss the reality of having a limb amputated in their youth by accident doesn't make for an easier old age for the accidental amputee let alone the ones that would have a limb removed. I would feel that the best tract to follow is research into fixing the brain aliment rather then increase the strain upon the body by cutting off a limb and making the amputee's life more difficult. Accidental amputee's endure the struggle with courage & gratitude for being alive because they have to & not because they wanted to. Life can be very very good to accidental amputee's but I think most would be pleased if they could have their limbs back. Is wanting a limb removed a deeper cry for mental help then the Biid wants to admit?? I don't ask that to belittle their problem but to address the severity of it.
Donnie, after 25 years of soul searching on the issue, the largest part of 20 of those assisted by therapists of all ilks, I can guarantee you that it's not a cry for mental help...
As for aging bodies... I'd rather have the next 5 years of being in a body that "fits" me and go downhill quickly than to spend the next 40 years in the same mental hell I've spent the last 35 years in.
I'm with you Wesley, it is a bad idea to let people suffering from mental illness hurt themselves. That does not make BIID sufferers any less tragic but when we start hurting people to help them, then we have surely lost all reason.
Sean and Clare: Thank you for sharing so openly here.
I was upset, and still am, that a psychiatrist would write you off and say there is nothing more to be done, Sean. There may not be an effective treatment to lower the decibals of your obsession, but there is always an opportunity for palliation via support and commitment to the patient.
I also went to your Web site. I was struck that the mutual support of BIID sufferers seemed to help people get through the night. We don't owe you acquiescence in amputation, but we do owe you care, concern, and committed empathy.
But it is not an anti disability bias that has us opposing the amputation of healthy limbs. It is a deep and abiding concern for you and the prevention of mahem, which is what this would be consent or no consent. Moreover, you don't KNOW that amputation is an effective treatment. And indeed, the cause remains elusive. That should be the effort, not surrender.
The concern is not against people with disabilities, it is not to participate in a terrible, and potentially life-threatening, harm to oneself.
There is also concern for the medical profession, that it not become facilitators of harm, as in this, or euthanasia, or other forms of a desire to self mutilate that might exist.
Jessie, how is it "hurting themselves" if the person is actually better off afterwards? I have talked to a man who, 20 years after he self-amputated his leg, has never had a moment's regret except that he didn't do it sooner. He didn't do himself any harm whatsoever, he cured himself. There's no hurting, no harm involved. He has not been hurt. Only peace, and a better life.
I know people who are very close to suicide over this issue. They have sought psychological and psychiatric help for years, tried various cocktails of drugs as well as mental exercises. Nothing touches it. Very little research is being done on this condition because it's so very rare, and the research that *is* being done is not specifically aimed at finding a cure, only at understanding the way the brain processes body image by looking at weird cases. We are a long, long way from a cure for BIID, and in the mean time, people are suffering, incredibly. Their lives are just as in danger as the life of a man who needs his leg amputated for bone cancer. And the means to end that suffering and save their lives is so close at hand.
I simply don't understand. Why is it so much infinitely preferable to suffer interminable mental anguish, than to live without a leg? I've had many conversations with many people about BIID, and no one has ever been able to answer that question for me. Someone answer that for me, please?
Thank you Wesley. The thing is, we *do* know that it is an effective treatment. I know many people who have done this and unanimously, they say it works, they're free, they're happy. Yes, we do know it works, but sadly, they need to put their lives in danger, rather than being cared for by a medical professional, in order to get there.
I'm with you on the "slippery slope" issue. I'm against abortion and euthanasia. I don't think people with anorexia have a right to starve themselves to death. But BIID is not a life-or-death issue (unless you want to look at it from the point of view of the danger of suicide and SELF-amputation). In the vast majority of cases, the surgery required would leave the BIID patient with a very manageable disability, one which would allow them to live a full, happy and productive life.
According to the complications within Biid it is a mental health issue Sean. So,me folks weighing 80 lbs and being 6 feet tall see themselves as fat. Should we not recopgnize their problem as a mental health issue or should we try and find ways to treat their mental health so that they can see themselves as they really are. Cutting a leg off is not a physical issue in any sense of the word.
You did a fine job of describing my own feelings on the issue Wesley. I feel that help must come to making the Biid people realize just how blessed they are to have the support of a medical community that seeks the best for patients by not cutting off body parts .
Claire said, "Their lives are just as in danger as the life of a man who needs his leg amputated for bone cancer." I'm sorry, but this is nothing more than hyperbole.
i admit that before today BIID was completely unknown to me and I do not entirely understand it. It is as foreign to me as people who cut themselves with razors. However, I have dealt with cancer and I must say that you are comparing apples and oranges. The affected body part of a cancer patient could very well kill them if it is not removed. In many cases it is not even an option; it has to go. Whereas the "affected" limb of someone with BIID will certainly not kill them and removing it is always optional, regardless of your arguments concerning mental health.
Anyone who suffers, whether mentally or physically, certainly needs our help. But dismemberment, please. I have to agree with Mr. Smith on this one.
But Donnie, not only do they not cut off body parts, they also do nothing else. I've seen three mental health professionals, my GP and an emergency room doctor, and they all told me "I've never heard of this." I have been told that it was "too marginal" to have much study done or for a treatment protocol to be addressed. They all just refer me to someone else who also hasn't heard of it and also doesn't know what to do. I DO NOT have the support of the medical community, other than near total inaction and passing the buck. The one person who I have seen who knew about the condition is conducting a study on BIID, and even he says that it's not to find a cure for BIID, it's to more about the brain. There is no other treatment in sight, because nobody's looking for it. I am far from thinking the medical community is working hard for our best interests, here, merely because they feel most comfortable in their inaction.
I wholeheartedly agree that we need to find a way to treat BIID mentally. I have participated in the one study that might eventually lead to this, traveling long distances at my own expense. But while we're waiting for someone in the medical community to even begin to be interested in researching that, there are people living in hell whose lives are in danger NOW. How else can we help those people, NOW, except by using the one treatment that has been show to work? Nobody who is against surgery seems to have any other answer except: "Suffer."
Hello Clair.
I feel quite badly that you are on your roller coaster ride and I pray that you will become more satisfied with who you are and not be fixated on who you want to be as an amputee. Being an athlete all my life as well as a hard worker quite involved with hobbies such as hunting,/trapping & fishing, canoeing hiking, I find your desires to be quite foreign to me. My dad was much like me but diabetes took his leg when he was 60 & his second one when he was 70. Dad had to make a new life for himself after the first amputation and he longed for the imperfection of having two legs again.
Ethnographic studies reveal that what we call BIID has been present for centuries. See the Human Relations Area Files to confirm this. Many cultures have not only condoned extreme forms of body modification but encouraged them. As Sean and Claire have pointed out, modifying one's body in a way that is not socially or medically accepted is an effective treatment for BIID. I am not advocating this but rather pointing out an inherent bias exists against performing certain procedures.
Wesley, At some level I think disability based bias does figure into this discussion. Disability history demonstrates that many heinous acts have been rationalized by a deep and abiding concern for disabled people. As a disabled man, I have learned that when others are worried about my well being and safety I am in deep trouble. For instance, it was not long ago that doctors and health care professionals urged (forced) parents to institutionalize children with cognitive deficits. In retrospect we all know this was medically and socially unacceptable.
I definitely feel that people should be protected from cutting their own limbs off, just like they should be protected from committing suicide. I am reminded of an episode recalled in Culture of Death in which a man who had cut off his own arm in a fit of madness was acceded to, causing the loss of his arm, which could have been re-attached. It is cruel and uncompassionate NOT to refuse to amputate the limbs of those suffering from BIID. While it is not "bad" to be disabled, cutting a limb off based on this argument is like arguing that conditions arising from TBI are not "bad," it would be okay to bash in the skulls of those who want a TBI. One has to do with diversity and living as a member of a specific community (the handicapped), the other has to do with causing grave physical harm to someone in order to help him or her join that community. I also think that this is unfair to those who are handicapped due to circumstances beyond their control-for instance, this could cause people to crowd the accommodation system so that people with legitimate physical disabilities have a harder time ensuring that they have access to services they need to be successful. Moreover, I think that most people are generally unprepared for the challenges they will encounter as a physically disabled person, and would be justiably angry and upset if their doctors acceded to their wishes and put them in this predicament. It's like someone who is suicidal-he or she thinks that she wants to die, until the pills have been swallowed-and then it is often too late. In this case, death isn't necessarily "bad" either, it is the circumstances under which it is met.
I can't believe that the BIID sufferers here keep saying that cutting off a healthy limb would not be harming themselves. It's like trying to re-define terms to make reality out the way you want it. _Of course_ removing a healthy limb is harming oneself. This is true *even if* it is/were true that doing so makes the person feel psychologically better afterwards.
Wesley, I was under the impression that in England, at one place at any rate, this limb-removal so-called "treatment" was already underway. Is this not the case?
Lydia, I think people that have BIID are a minority within a larger group of people that radically modify their bodies. Thanks in large part to the internet, an entire community of people has formed in reality and in cyber space that practice extreme forms of body modification. People in this community I have met do not seek out medical advice because they know doctors will be judgmental or classify them as mentally ill. Some of the comments here simply reinforce this concern. This discussion also narrowly focuses on amputation rather than other more common forms of body modification.
Lydia: I don't think it is done in the UK. I am at Chicago/O'Hare and so this is off the top of my memory. I recall one patient being amputated (in Mexico?), and as I recall that patient died. It might have been in the UK though.
William: Big difference between things like branding and radical piercing, which has its own disturbing ramifications but does not destroy body function, and cutting off a healthy limb. I don't even think people with BIID would consider it body art or a statement of individuality in the same sense. Their affliction, as we have seen from the frank postings here, are not a shart turn toward primitivism.
Lydia, Dr Smith in Scotland performed two elective surgeries a few years ago. The two patients have found peace and are happy. A third surgery was scheduled but the media got hold of the story and such a zoo ensued that the hospital stopped proceedings.
The last thing I will say follows Claire's point: If you won't accept surgery, then provide us with a viable and working alternative.
As for the rest of the discussion, I've said my bit. I do not have the energy to rehash the same thing. Either you get it, or you don't. If you don't, by this point, it's quite obvious to me that you won't.
If someone has a psychological disorder that makes him feel like his head is an alien part of his body, are we obligated either to provide him with a treatment that will get rid of his psychological pain or else countenance cutting his head off?
Is a disabled state is intrinsically worse than an abled state, even if the the person in such a state is of the opposite opinion? I'd have said the only person who would judge what state is intrinsically more valuable is the person in such a state, or else the value judgement is extrinsic.
So, I argue that isn't harmful to allow somebody to change their body to a state they desire, regardless of what anyone else thinks about such a change. And such a change is not harm, so we are not allowing self-harm either.
The only possible way you could argue against that it is self-harm is if you believe the person will later regret the change they have done to their body, but from what I've read here, that probably wouldn't be the case.
William: you accused me of hyperbole when I said that BIID could be fatal, but I'm afraid you're wrong, sadly. Suicide is a very real possibility, as is death from botched self-injury attempts, or, in the case of the guy in Mexico that Wesley mentioned, by a doctor in a third world country who (I believe for the sum of $10,000) performed the procedure without providing adequate medical care afterwards and the guy died of gangrene in a hospital room. I'm sorry you don't believe me, but regardless of your belief, BIID can indeed, and has been, fatal.
Wesley: You are correct in that it's not a body modification issue. It's a mental illness caused by a congenital defect in the part of the brain that processes body image. It's not about achieving a certain look or being different. Thank you, btw, for your compassion. While I don't agree with you on the surgery issue, you've treated us with respect. I appreciate that. One of your readers, a "biblical Christian", kindly refers to us as "nut jobs" (http://bibliopolit.blogspot.com/2008/11/nut-jobs-limb-ping.html). Funny, I never read in the Bible where Jesus mocked those with mental illnesses. :-/
Honestly, I do understand why so many people are against surgery as an option. I am against surgery for severe cases (Lydia's example does not apply, as that involves actually killing the person), for example I once talked to someone who needed desperately to be a vent-dependent quad...I can't wrap my head around that myself. I don't even want surgery for myself. It's only for VERY severe cases of BIID, not everyone, and many of us can manage without it. But for some people, it's absolutely necessary, before they die of it. I'm truly frightened for their lives...and these are people I know personally, friends I care about. Remember, while this is new to *you*, we have suffered all our lives. Since early childhood.
I've asked repeatedly, and no one has answered...why is it better to be physically whole and in great mental distress, than to be mentally healthy and happy with a manageable physical disability? And if you're against surgery, then don't you have to provide an alternative? No one answers that question. I've asked it. Sean has asked it. What would you have us do? While doctors rail against the only treatment that has been known to work, they steadfastly refuse to provide any other treatment, leaving us without choices, and nowhere to turn. I'm at a loss.
Whoops, made an error above. The guy in Mexico died in a HOTEL room. No hospital care was provided.
Actually I did answer you Claire. The risk factor of having a limb removed is relevant as aging takes place. Say you remove a leg and nature removes your second leg? You remove an arm and a second arm is amputated in a freak accident??? You diminish your body every time you lose a limb for a false pride in my estimation. The mental problem is what needs to be addressed not a physical problem that you don't have and have convinced yourself that you do have. A perfectly healthy body doesn't deserved to be carved up because of a mental issue in my humble opinion. As I state above , "I as a person who loved everything that I got out of life in athletic endeavors am having a hard time adjusting to ideology of self mutilation.
Claire-I do not think it is better to be physically whole yet in profound emotional distress-I agree that the handicapped state is not bad and should be understood as a faction of one's identity with that particular people group, which has valuable things to contribute to society which have not been tapped due to profound discrimination.
What I think, however, is that if a doctor amputated your limbs, he would be doing you a profound disservice if a)a cure was found, thus enabling you to feel regret over made that decision, b)you found life with a physical disability worse than what you are currently experiencing, due to the prejudice and lack of accessibility that currently exists in society. Moreover, I am also concerned about the long-term implications of such procedures for others with mental illnesses, such as the situation Wesley mentions in his book, Culture of Death, when doctors did not re-attach the limb of someone suffering a mental breakdown because he viewed the limb as evil. Doing so abandons you and others with mental illnesses to whatever your illness predisposes you to do. As I've cited, it's a bit like not responding to someone who wants to commit suicide-it is competely uncompassionate to say to such a person, "I respect your decision to jump of a bridge, go ahead," even if that person truly feels that death would be preferable to living in constant agony. To me, this communicates the attitude that whoever is allowing you to jump off the bridge doesn't care enough to stop you from doing it.This perspective does not stem from a personal belief that death is "bad," but one that sees such a decision as inverting the universal survival instinct, which either indicates deep dispair or mental illness. As human beings, we are responsible for relieving agony and illness, whether it be mental or physical. Cutting off a limb, like killing oneself, is also a permanent solution that cannot be changed. If it could be changed depending on how someone felt about their new physical state, than I might be a bit more supportive of that solution.
As Wesley said, I'm happy that you and Sean are here sharing your experiences. The more that you talk to people about what you are experiencing, the better able we are to help you and understand. You will both be in my thoughts/prayers as I work on how I can better assist the greater disabled community.
Sean and Claire, thanks for the explanation. I had previously thought that BIID was totally a mental disorder. How can amputating, for instance, a leg, solve the problem when the leg itself isn't the problem? If the problem lies in the brain not recognizing the leg as part of the body, that makes more sense.
I have to think that some way can be found to integrate the body. There are some really interesting things being done to compensate for nerve damage - the brain being rewired to perform tasks a different way. Here is a fairly dramatic example. And I've read about amputees having phantom pain, being helped by therapy using a mirror so that their brains could resolve the fact that the limb just wasn't there anymore. So there has to be something that can be done.
Your story about the doctors dismissing you with "I've never heard of that" is infuriating and, unfortunately, all too believable. When you get a doctor with enough imagination to not deflect anything that doesn't make sense to him/her right away, hang onto that doctor at all costs - and that goes for all of us.
Wow. I came into this game late and I came in having to read through everyone's arguments before I could get a clear picture of the issue.
There's so much that I want to say here, and there's so much that needs saying, but I don't know that I can be eloquent enough to say everything right. Please bear with me.
BIID is a horrible curse, and everyone who has that particular cross to bear is far stronger than I could ever be, for managing to survive day and night with this condition.
Everyone who suffers BIID is a human being, deserving of love, friendship, and support. And I agree that I don't know of any method to help aleviate the pain of suffering except possibly amputation.
I don't think that any person should be harmed in any way. Having a limb removed does harm to the body. Ask any diabetic who has had a leg removed; the strain that the body goes under can be pretty horrific. While mental peace might be achieved, the body isn't meant to sustain such damage.
It's irresponsible of any medical practitioner to reduce BIID, to blow it off, or to not make sure it's properly treated.
I'm *extremely* sympathetic in this area because I don't see any issue with people who are physically handicapped, and because, having major depression that arises as panic disorder, I know the hell of having everything hurt and feel wrong and feeling alien in your own skin. Of course, that's *nothing* like BIID, but I can imagine that I could take my pain and triple it, and that might be close.
I would say first that all effort to resolve the problem without surgery must be made first. This is too complicated for doctors to blow off as a sort of meat market. "You have BIID? End of the line - yo, Charlie! Nother arm comin' off at the back!"
That has to be one of the most disgusting things I ever though of, but it's a big fear of mine - that people will be reduced to cattle, and that sufferers of such disorders as BIID will be thrown away as useless. Probably because I have depression, it worries me more - I don't want to be thrown away, either. Everyone should be treated like they're precious.
Second of all, I have to say that there are people out there who pervert -anything- they get their hands on. I had the misfortune once of following the wrong website links. Because of my love of anime and manga (Japanese cartoons and comic books), I like to visit Japanese websites, but I don't speak or read the language. And, misfortunately, I happened upon a pornographic website where human amputations were done as a means of erotica. It was very bloody and messy and I was scared to troll Japanese websites for a while there.
There are plenty of people who will see someone with an illness like BIID as a target. As bad as being thrown away, being used is another danger of giving in to the desire to amputate. People dehumanize others who are amputees, who have physical deformities, who are physically or mentally different in any way. A sufferer of BIID who amputates is at risk for exploitation by thoughtless, criminal minds. I only had to look at that website once to know they're out there.
In this way, I think, Wesley is right about BIID amputees being bad for society. Or rather, I think that society is bad for BIID amputees.
Society has to step in and make damn sure that every one of you is given the support needed to make it through another day. And all too often, society will treat someone who is different as a commodity, not a person.
How long before someone who has BIID, or who is depressive, or who is abnormally short, is considered "defective" and disposed of in some unpleasant way?
I probably wouldn't have responded to this one because it's so far outside my norm, except I was *very* disturbed by that website. With a little searching I'm sure I can find it again, if anyone disbelieves me, but I don't want to post a link here unless I'm asked to. It was scary, and I don't want it happening to people in real life.
To answer your question, Gregory, we are not our bodies. We may be our minds, however, and minds seem to be a product of our brains. A change to my body doesn't change who I am (at least, not more than a change to another part of my life, such as losing one's house changes who one), yet if I suffered brain damage that might well change who I am (or even cause me to forget who I was).
However it is our goal to maintain as perfect a mind as we can and not fall victim to cutting pieces out of it or of the mobility & dexterity that our body gets from our mind.
For myself:
I say, I am my soul, but my soul requires a body. My brain is an organ that sends input into my intellect and helps me to deliver output. My body is important to me because it was given to me specifically.
Any parts of the body that I have that I don't like or want to change or get rid of, I can only alter in a respectful way, because the hatred of the body is a form of self-hatred.
Someone with BIID doesn't recognize a part of his body as bieng part of himself, and therefore doesn't want it attached. Every effort to comfort and heal a person with BIID must be made, because the body is meant to be integrated, not dismembered.
Claire,
I think that you have still missed my point. The fact of the matter is this; if someone with BIID simply does nothing, then they will not die. Nothing includes not committing suicide, not going to a third world country for surgery, and not attempting self surgery. If they simply ignore the problem, it will not kill them. I know that you will say that this is impossible, but for the sake of argument grant for a minute that it is. However, if someone with an acute case of bone cancer tries to ignore it, it will definitely kill them. I am not saying that BIID does not cause people to suffer. I am simply saying that BIID, by itself, does not kill anyone. A death by BIID always requires some action on the part of the patient.
I wasn't planning on coming back, but William's point is new and interesting.
I think that part of the porblem is that there is a value judgement that says that having a physical impairment is "ipso facto" worse than mental suffering. If we put equal value to both aspects, then the question of altering the body to create peace of mind would become obvious.
Let me ask you this William: From an ethics point of view, is "life at any cost" better than death?
People in concentration camps & suffering long term cancer cures prove life at any costs can be rewarding. Those folks made this their goal. "I will stay alive at all costs, and refuse to give up. They reasoned that " someday the good soldiers will rescue me or the good medicine man will cure me."
It's not necessarily "life at any cost," but "hope for something better." This is a generation that's lost hope. Holding on despite the pain and anguish may lead either to eventual death, or maybe to a better circumstance. Giving up is giving up on hope. Hope is something that should be part of our bone structure, but nobody espouses it anymore.
Sean,
The simple answer is, no. I would rather die than forsake my God or my family. As I said earlier, this is foriegn to me. I can not imagine wanting to cut off my leg any more than I can imagine suicide. But that's not to say that other don't deal with these issues, because I know that they do.
My point is simply this; BIID is not like bone cancer and to compare the two as if they were the same is hyperbole. When you make a statement that is so blatantly inflated it diminishes the impact of your argument.
Well said Mr Peace. I feel much the same.
William,
You're right, BIID and cancer aren't the same. One must take action to die from BIID. But the argument is not inflated. I guess it might be that you haven't experienced the utter despaire and pain (yes, physical pain as well) related to BIID. It is one of those things that is easy to dismiss through lack of real understanding, particularly as it is so intangible.
I have had times where I did not leave the bed, for days, not even to go to the loo, because I was in so much distress. I have had times I wanted to smash my head against a brick wall to make it stop. The older I get, the harder it gets. There is a constant feeling in the pit of my stomach that it's a big churning mass. It is one of those things that is nearly impossible for me to explain to someone who hasn't experienced it. But it is insidious, it is growing, it is impairing, and it will kill me. Maybe I need to take action for me to die, but that action will be the direct result of a lifetime of intense suffering.
Donnie, you're right, people in concentration camps and some people going through cancer cures have gone through hell and survived. Perhaps they are just better people than me. I lost real hope after about 30 years of dealing with BIID. I kept reasoning that the psychiatrists would find a way to handle BIID. I kept reasoning that maybe this, or that drug would work. I kept *hoping* I would wake up one day and it would be gone. Not just sitting there iddly, but working on it.
I guess in a way I still do have hope, because I haven't taken the final step. But that might be more cowardice than anything else, really.
Sean: I so deeply appreciate your commenting here and helping us understand the agony which you experience.
As to "final steps," it isn't cowardice to continue on in the face of great suffering. To the contrary. It is courageous and inspiring. If that effort begins to falter, please seek help. It sounds from your use of the word "loo" that you are in the UK?
We care about you and your fellow sufferers of BIID tremendously. And we are all so sorry for what this awful condition is putting you through.
Wesley: Cowardice rather than courage, because what stays my hand is fear of missing, hurting myself in ways I don't want to, etc.
As for seeking help... What help do you speak of? Seriously. It's what Claire and I have been trying to say all along. THERE IS NO HELP.
If I get really suicidal and go see a shrink, what can he do? Lock me up, section me and put me under observation. He cannot provide a solution to BIID. Psychotherapy has not worked. Pharmacotherapy has not worked. None of the tools available to psychiatrists, psychotherapists and doctors in general have touched BIID. So, lock me up while I'm thinking about suicide, but you'll have to lock me up for life, because BIID isn't getting better.
Which brings me back to the question "life at all costs?". Locked up in the psych ward, enduring a living hell that no one can do anything about, unless they are willing to provide surgery.
It is a value judgement that physical integrity is better than anything else. Many of my disabled disability advocate friends would argue that it is neither better, nor worse.
Hello Sean.
I want you and Clair to know something about me in particular. I have never met you but I am praying that you accept God's gift of having all your limbs. I know people born blind, deaf and mute. I have met folks born with stumps for appendages. They learned to find joy in life even though they had natural defects which made life more difficult to them. Some folks are born with low levels of mentality but they are a blessing to the human race because they make the so called gifted folk happy to share in their triumphs. You are important to the human family Sean despite what you class as imperfections even though you know in your heart that others view your physicality as normal.
Donnie, I was married for several years to a woman who was paralysed in a car accident when she was a teenager. I call *many* people with disabilities close friends. I have worked in the field of disability rights and services for nearly ten years. I know you didn't mean it that way, but I'm pretty sure most would find your comment of "them being a blessing" to be patronising.
Could you possibly conceive that what *you* view as imperfections, missing or paralysed limbs, are in fact not imperfections, but merely a neutral state, albeit different? It requires you to change your paradigms, which is not easy to do. But once you begin to understand that impairments are not, in and of themselves negative, your view may change. If you're interested, Google "Social model of disabilities"
Smith is with his argumentation very near Adolf Hitler, Kalr Marx and Sigmunf Freud. What do you expect from an ideologist?
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