A (Seemingly) Very Rare but Interesting Mental/Emotional Disorder: A Case Study for Medical Ethics

A (Seemingly) Very Rare but Interesting Mental/Emotional Disorder: A Case Study for Medical Ethics September 7, 2017

A (Seemingly) Very Rare but Interesting Mental/Emotional Disorder: A Case Study for Medical Ethics


Recently I became aware of a mental/emotional/personality disorder in which a person claims he or she cannot be happy or fulfilled without a limb amputation. And the desire for the limb amputation has no other cause or reason. To read about it use key words (using an internet search engine) such as: apotemnophilia (a word being dropped by psychologists), body integrity disorder and even paraphilia.

Apparently, from what I have been able to discern from reading, the disorder is never a “passing fancy” but is long-term and profound. The person with this disorder (whatever the proper name should be and that is under discussion among professionals) claims to be unhappy with his or her body and claims that happiness can only be achieved with limb amputation. There is no way to know how common this disorder is because many people with it go most of their life without reporting it to any professional researcher or medical doctor or therapist. However, it is common enough to have entered the literature and become the subject of intense research and debate.

*Sidebar: The opinions expressed here are my own (or those of the guest writer); I do not speak for any other person, group or organization; nor do I imply that the opinions expressed here reflect those of any other person, group or organization unless I say so specifically. Before commenting read the entire post and the “Note to commenters” at its end.

Some people with this disorder say that they cannot achieve full sexual satisfaction without fantasizing about a limb amputation. Very little is known about whether such satisfaction is achieved by means of limb amputation because very few surgeons are willing to perform surgical limb amputation for this reason alone. However, some persons suffering this disorder have actually harmed a limb in order to force its amputation. (Although the literature I have read gives no “real life” examples of this beyond very minor attempts that did not lead to limb amputation.)

Of course, this disorder is now beginning to raise ethical questions. Ought a person with this disorder—once it is professionally diagnosed—be given his or her desired limb amputation in order to achieve happiness and/or sexual satisfaction? And, of course, who would pay for that?

From what I can tell, this is “cutting edge” in medical ethics and even many medical ethicists have simply not chosen to enter the debate.

However, I predict that as the disorder becomes better known (via television and print media) a debate about it will erupt.

I teach Christian ethics; I hold a named professorship in Christian ethics. So…

It seems to me this will become a quandary and matter of decision not only for secular society but also for church leaders—especially as they are consulted by Christian medical and psychological professionals who are confronted with people with this disorder.

The secular-society question will be (I predict) whether surgeons should amputate limbs, as requested, for the sake of the patients’ happiness (once they are professionally diagnosed). If the answer becomes “yes,” then the question of whether insurance should cover such surgery will be raised and debated.

I predict this will become a public issue within twenty-five years or less (just a guess). All it will take is for the popular media to offer case studies of people with this disorder and of medical ethicists and doctors who argue that such people should be given the desired surgical amputation. Especially if the case studies (e.g., on a primetime network television “magazine program”) claim with professional support that this is a sexual identity.

A question is: Will Christian medical (and other) ethicists take this up for discussion and possible decision (e.g., advice to church professionals) before then or only then?

(In this case, in spite of the “Note to commenters” below, I invite secular people to offer thoughts and opinions, not just questions, so long as they are expressed in a civil, thoughtful manner. But give reasons, not just assertions. The same goes for everyone who responds.)

*But please do no post lengthy, technical explanations or arguments and especially (!) do not post hyperlinks here.

*Note to commenters: This blog is not a discussion board; please respond with a question or comment only to me. If you do not share my evangelical Christian perspective (very broadly defined), feel free to ask a question for clarification, but know that this is not a space for debating incommensurate perspectives/worldviews. In any case, know that there is no guarantee that your question or comment will be posted by the moderator or answered by the writer. If you hope for your question or comment to appear here and be answered or responded to, make sure it is civil, respectful, and “on topic.” Do not comment if you have not read the entire post and do not misrepresent what it says. Keep any comment (including questions) to minimal length; do not post essays, sermons or testimonies here. Do not post links to internet sites here. This is a space for expressions of the blogger’s (or guest writers’) opinions and constructive dialogue among evangelical Christians (very broadly defined).

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