Amputees By Choice: Body Integrity Identity Disorder and the Ethics of Amputation


Tim Bayne Department of Philosophy Macquarie University Sydney, NSW 2109 Australia

Neil Levy Centre for Applied Philosophy and Public Ethics Department of Philosophy University of Melbourne Parkville Vic 3010 Australia


ABSTRACT Should surgeons be permitted to amputate healthy limbs if patients request such operations? We argue that if such patients are experiencing significant distress as a consequence of the rare psychological disorder named Body Integrity Identity Disorder (BIID), such operations might be permissible. We examine rival accounts of the origins of the desire for healthy limb amputations and argue that none are as plausible as the BIID hypothesis. We then turn to the moral arguments against such operations, and argue that on the evidence available, none is compelling. BIID sufferers 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.