Out on a Limb: The Ethical Management of Body Integrity Identity Disorder
- Christopher James Ryan
- … show all 1 hide
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Body integrity identity disorder (BIID), previously called apotemnophilia, is an extremely rare condition where sufferers desire the amputation of a healthy limb because of distress associated with its presence. This paper reviews the medical and philosophical literature on BIID. It proposes an evidenced based and ethically informed approach to its management. Amputation of a healthy limb is an ethically defensible treatment option in BIID and should be offered in some circumstances, but only after clarification of the diagnosis and consideration of other treatment options.
- Dotinga, R. 2000. Out on a limb. Salon [August 29].
- Dyer, C. 2000. Surgeon amputated healthy legs. British Medical Journal 320: 322. CrossRef
- Johnston, J., and C. Elliott. 2002. Healthy limb amputation: Ethical and legal aspects. Clinical Medicine 2: 431–435.
- Bayne, T., and N. Levy. 2005. Amputees by choice: Body integrity identity disorder and the ethics of amputation. Journal of Applied Philosophy 22: 75–86. CrossRef
- Savulescu, J. 2006. Autonomy, the good life and controversial choices. In The Blackwell guide to medical ethics, eds. R. Rhodes, L. Francis, and A. Silvers. New York: Blackwell.
- First, M.B. 2005. Desire for amputation of a limb: Paraphilia, psychosis, or a new type of identity disorder. Psychological Medicine 35: 919–928. CrossRef
- Berger, B.D., J.A. Lehrmann, G. Larson, L. Alverno, and C.I. Tsao. 2005. Nonpsychotic, nonparaphilic self-amputation and the internet. Comprehensive Psychiatry 46: 380–383. CrossRef
- Sorene, E.D., C. Heras-Palou, and F.D. Burke. 2006. Self-amputation of a healthy hand: A case of body integrity identity disorder. Journal of Hand Surgery 31B: 593–595.
- Braam, A.W., S. Visser, D.C. Cath, and W.J.G. Hoogendijk. 2006. Investigation of the syndrome of apotemnophilia and course of a cognitive-behavioural therapy. Psychopathology 39: 32–37. CrossRef
- Baubet, T., B. Gal, S. Dendoncker-Viry, A.C. Masquelet, M.T. Gatt, and M.R. Moro. 2007. Apotemnophilia as a contemporary frame for psychological suffering. Encephale 33: 609–615. CrossRef
- Bensler, J.M., and D.S. Paauw. 2003. Apotemnophilia masquerading as medical morbidity. Southern Medical Journal 96: 674–676. CrossRef
- Money, J., R. Jobaris, and G. Furth. 1977. Apotemnophilia: Two cases of self-demand amputation as a paraphilia. Journal of Sex Research 13: 115–125. CrossRef
- Everaerd, W. 1983. A case of apotemnophilia: a handicap as sexual preference. American Journal of Psychotherapy 37: 285–293.
- Bruno, R.I. 1997. Devotees, pretenders and wannabes: Two cases of factitious disability disorder. Sexuality and Disability 15: 243–260. CrossRef
- Wise, T.N., and R.C. Kalyanam. 2000. Amputee fetishism and genital mutilation: Case report and literature review. Journal of Sex & Marital Therapy 26: 339–344. CrossRef
- Storm, S., and M.D. Weiss. 2003. Self-inflicted tourniquet paralysis mimicking acute demyelinating polyneuropathy. Muscle & Nerve 27: 631–635. CrossRef
- Elliott, C. 2000. A new way to be mad. Amputations sought by healthy people. The Atlantic Monthly 2866: 73–84.
- British Broadcasting Corporation. Complete Obsession. 2000. Horizon. 17-2-2000.
- Australian Broadcasting Corporation. Enough rope: Three amputees. 2006. Enough Rope. 28-8-2006.
- Furth, G., and R. Smith. 2000. Apotemnophilia: Information, questions, answers and recommendations about self-demand amputation. Bloomington: 1st Books.
- Smith, W.J. 2005. Should doctors be allowed to amputate healthy limbs? Newsletter of the Center for Bioethics and Culture Network.
- Large, M.M. 2007. Body identity disorder. Psychological Medicine 37: 1513–1514. CrossRef
- Schlozman, S.C. 1998. Upper-extremity self-amputation and replantation: 2 case reports and review of the literature. Journal of Clinical Psychiatry 59: 681–686.
- Sadock, B.J., and V.A. Sadock. 2007. Kaplan and Sadock’s synopsis of psychiatry, 505. Baltimore: Lippincott Williams & Wilkins.
- Feinberg, T.E., and D.M. Roane. 2005. Delusional misidentification. Psychiatric Clinics of North America 28: 665–683. CrossRef
- Gardener-Thorpe, C., and J. Pearn. 2004. The Cotard syndrome. Report of two patients: With a review of the extended spectrum of ‘délire des négations’. European Journal of Neurology 11: 563–566. CrossRef
- Lepping, P., I. Russell, and R.W. Freudenmann. 2007. Antipsychotic treatment of primary delusional parasitosis. British Journal of Psychiatry 191: 198–205. CrossRef
- Berrios, G.E., and R. Laque. 1995. Cotard’s syndrome: Analysis of 100 cases. Acta Psychiatrica Scandinavica 91: 185–188. CrossRef
- Grant, J.E., and K.A. Phillips. 2005. Recognizing and treating body dysmorphic disorder. Annals of Clinical Psychiatry 17: 205–210. CrossRef
- Crerand, C.E., M.E. Franklin, and D.B. Sarwer. 2006. Body dysmorphic disorder and cosmetic surgery. Plastic and Reconstructive Surgery 118: 167e. CrossRef
- Phillips, K.A. 2002. Pharmacologic treatment of body dysmorphic disorder: Review of the evidence and recommended treatment approach. CNS Spectrums 7: 453–460.
- Koran, L.M., E. Hollander, G. Nestadt, H.B. Simpson, and American Psychiatric Association. 2007. Practice guideline for the treatment of patients with obsessive-compulsive disorder. American Journal of Psychiatry 164: 5–53.
- Krahn, L.E., H. Li, and M.K. O’Connor. 2003. Patients who strive to be ill: Factitious disorder with physical symptoms. American Journal of Psychiatry 160: 1163–1168. CrossRef
- Lawrence, A.A. 2006. Clinical and theoretical parallels between desire for limb amputation and gender identity disorder. Archives of Sexual Behavior 35: 263–278. CrossRef
- Bottini, G., E. Bisiach, R. Sterzi, and G. Vallar. 2002. Feeling touches in someone else’s hand. Neuroreport 13: 249–252. CrossRef
- Ramachandran, V.S., and P. McGeoch. 2008. Can vestibular caloric stimulation be used to treat apotemnophilia? Medical Hypotheses 69: 250–252. CrossRef
- Edgerton, M.T. 1973. Transsexualism—A surgical problem? Plastic and Reconstructive Surgery 52: 74–76. CrossRef
- Centers for Disease Control and Prevention. Unexplained dermopahty (aka “Morgellons”). http://www.cdc.gov/unexplaineddermopathy/general_info.html. 2008.
- Koblenzer, C.S. 2006. The challenge of Morgellons disease. Journal of the American Academy of Dermatology 55: 920–922. CrossRef
- Murase, J.E., J.J. Wu, and J. Koo. 2006. Morgellons disease: A rapport enhancing term for delusions of parasitosis. Journal of the American Academy of Dermatology 55: 913–914. CrossRef
- British Broadcasting Corporation. The Goodies—Punky business. 1977.
- Smith R. Body integrity identity disorder: Advice of surgeons. http://www.biid.org/advice.php?page=06&lan=en. 2008. www.biid.org.
- Law, S.A. 1995. Silent no more: physicians’ legal and ethical obligation to patients seeking abortions. Review of Law and Social Change 21: 279–321.
- Lanzetta, M., P. Petruzzo, R. Margreiter, J.M. Dubernard, F. Schuind, W. Breidenbach, S. Lucchina, S. Schneeberger, C. van Holder, D. Granger, G. Pei, J. Zhao, and X. Zhang. 2005. The international registry on hand and composite tissue transplantation. Transplantation 79: 1210–1214. CrossRef
- Australia and New Zealand Dialysis and Transplant Registry. 2006. Australia and New Zealand Dialysis and Transplant Registry Report 2006. Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia.
- Out on a Limb: The Ethical Management of Body Integrity Identity Disorder
Volume 2, Issue 1 , pp 21-33
- Cover Date
- Print ISSN
- Online ISSN
- Springer Netherlands
- Additional Links
- Body integrity identity disorder
- Author Affiliations
- 1. Department of Psychiatry, University of Sydney, Westmead Hospital, Westmead, NSW, 2145, Australia