Essay: Apotemnophilia phenomenon

Paste your essay in here…To have informed consent, patients need to be in possession of relevant facts and also of their reasoning faculties. A mental disorder such as body integrity identity disorder would imply that one lacks their reasoning faculties. Inability to make rational decisions due to lack of consciousness or the inability to think rationally because of extreme pain (emotional or physical) is what renders most patients unable to give informed consent in today’s medical community.

 

Apotemnophilia tend to stress that from a very early age, in some cases as young as five or six years old, that they feel like their bodies do not belong to them, they typically state that they concluded that they want body amputations by the onset of adolescence. Researchers provide many theories for the so-called “apotemnophilia phenomenon”. Some speculate there may be brain deformities that cause a lack of proprioception in the afflicted limb. However, from the standpoint of the afflicted patient, there is no point in discussing the reasons why apotemnophilia exists, because it will not change the fact that their desired outcome is amputation. This being the case, the current classification of the disorder as psycho-sexual in nature makes the time and attention needed for medical professionals to pursue treatment extremely challenging to obtain.

Sexual or non-sexual urge-related paths that lead to apotemnophilia converge at the point of amputation as the desired treatment. Apotemnophilia do not allow themselves the idea of “no amputation” as an alternative. The ethical dilemma this introduces is that if a surgeon does not perform the amputation in a safe environment, the apotemnophilia may conduct an amputation at home or a non-professional manner, where their life would be put at a serious risk. There have been numerous discussions of how apotemnophilia have threatened suicide. Dr. Smith warned of the dire consequences of not respecting the decisions of these patients, and stated that, “they may take the law into their own hands, they may lie on a railway line and get run over by a train. They may use shotguns and shoot their limbs off. They are quite a desperate bunch.” This dilemma is like the treatment of chronic pain, clinical depression, or even pregnancy termination in jurisdictions where abortion or access to reproductive healthcare is restricted or illegal. The fact that individuals are willing to go to such risks to perform these surgeries highlights their inability to give informed consent for amputation surgeries.

Arguments against performing amputations and surgeries are based on the fundamental idea of maleficence. Avoiding maleficence requires medical professionals to do their utmost to avoid harming patients (whether by committing action or neglecting to perform an action that could save someone from harm). Beauchamp and Childress’ wrote in Principles of Biomedical Ethics, that this concept dates back to ancient Greek philosophy famously known as the Hippocratic oath. While surgery for elective amputation would resolve the feeling of holding an unwanted limb for a patient, it does resolve the underlying neurological cause. This is primary reason that most physicians do not want to pursue performing an amputation surgery.

The concept of harm is extremely complex in context with the disorder. Medical professionals must weigh the effects of what would be considered harmful in relation to understanding the conditions of someone facing a mental disorder or even a cognitive disability.