Body Integrity Identity Disorder and the Ethics of Mutilation

Abstract

Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. IntroductionChristian theology teaches the goodness of the material world, a goodness that was declared in creation, vindicated in the resurrection, and will be fulfilled in the world's redemption. The material world includes the human body, and acceptance of the body as the gift of a good Creator, as something neither to be worshipped nor to be escaped, lies at the heart of Christian thinking about the practice of medicine. It has also grounded a critique of those technological modes of thought characteristic of the modern world that explicitly or implicitly suggest the desirability of disembodiment and celebrate the freedom of the self to live unencumbered by the fatedness of gross matter.The critique of the technological mind-set is extremely attractive, and has rightly received much attention. 1 Nevertheless in its outworking in relation to modern medicine, it runs certain dangers, particularly when it treats of certain experiences, standardly treated as psychiatric disorders, in which people find themselves in some sense alienated from and in conflict with their bodies. The most obvious example of this is the experience of transsexualism, where a person finds himself or herself feeling at odds with his or her anatomical sex. The affirmation of the goodness of the body might suggest that the clinical response must be psychotherapeutic in nature, and must eschew sexual reassignment surgery. 2 Yet the case may not be so straightforward. I will explore this, not through a study of transsexualism, which involves broader questions of sexuality and gender, but through the much more unusual situation in which individuals desire the amputation of a healthy body part. By considering the appropriateness of a surgical remedy for psychological distress in this situation, we may be able

Gender Reassignment Surgery: A Catholic Bioethical Analysis

“…Robert Song argues that the principle of totality as expounded by Pius XII and Gerald Kelly provides a moral justification for amputation to alleviate body dysmorphic disorder. 70 By implication, it seems the same justification could apply to GRS.…”

How Autonomy Can Legitimate Beneficial Coercion

“…paternalism) in medicine. The principle of respect for autonomy is achieving increasing precedence in medical ethics (O'Neill, 2002;Song, 2013), carving out a domain in which beneficence-based judgements should not operate.…”

Autonomy, Competence and Non-interference

“… 2 This case is not dissimilar from the case of Robert Smith, who performed a healthy limb amputation for a patient in 1997 (Bayne and Levy 2005 , 75). For further discussion of the ethics of voluntary amputation see: Patrone ( 2009 ), Bridy ( 2004 ), Song ( 2013 ), Ryan ( 2009 ), Schramme ( 2008 ), White ( 2014 ). …”