Neuroethics author argues that autonomy must be respected

People who want one of their limbs amputated should be recognised as having a defined psychiatric disorder, says the editor of the bible of psychiatry, the Diagnostic and Statistical Manual of Mental Health Disorders. Dr Michael First, a professor of clinical psychiatry at Columbia University in New York City, has been studying this rare condition since 1999. He says that people suffering from it feel strongly that one of their limbs does not belong to them and should be amputated. He calls the ailment Body Integrity Identity Disorder.

The consequence of being included in the manual is that a standard treatment can be recommended. In Dr First’s view, the only effective one seems to be amputation. "People that have had amputations have claimed to be cured," he told Fox News, "so I’m going to get a hold of these people who’ve had the amputations and find out if this is really true. Hopefully this should provide more insight about whether surgery is really a viable option."

And in the current issue of Neuroethics, a Sydney psychiatrist argues that amputation of a BIID patient is not only ethical, but that doctors who do not want to treat must refer to a doctor who will. His main argument is that doctors should respect their patients’ autonomy if they have made a rational and informed choice.

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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