Amputation as a treatment for BIID

[JJM 777]

How about amputation of a brain part where the disorderly thought is stored, instead of amputating a limb, penis or vagina?

 

[Luciana]

Do you have any evidence for this? It seems completely bizarre to me. Anecdotally there is plenty of evidence that few people care consciously or unconsciously about disaster survival, given the levels of obesity, lack of physical fitness, ignorance about living outside of cities, willingness to get pregnant etc, etc, around the world.

Should I have any evidence for what I consider to be a gut reaction? I said that this was nothing more than my opinion. I was offering a possibility regarding a matter that, according to all those involved, has been scantily investigated.

Perhaps some of hatred towards extremely obese people is the realization that, perhaps willingly, those people are disabling themselves?

Because it's completely counterintuitive to desire to disable yourself. And why is that? Because, perhaps, deep down, we realize we might need all our strength, that it's better to be more physically capable than less capable. Just in case.

This kind of thing doesn't escape the attention of the obese who, jokingly or not, point out that they would resist a famine longer because of their fat reserves. In developed countries people no longer fear hunger... but just a couple of centuries ago this was quite a common occurence.

As an aside, a small English/survival tip, you want to run towards prey, but away from predators.

Oh, yes, I wrote that in a hurry.

 

[Guybrush Threepwood]

Should I have any evidence for what I consider to be a gut reaction? I said that this was nothing more than my opinion. I was offering a possibility regarding a matter that, according to all those involved, has been scantily investigated.

Perhaps some of hatred towards extremely obese people is the realization that, perhaps willingly, those people are disabling themselves?

Because it's completely counterintuitive to desire to disable yourself. And why is that? Because, perhaps, deep down, we realize we might need all our strength, that it's better to be more physically capable than less capable. Just in case.

This kind of thing doesn't escape the attention of the obese who, jokingly or not, point out that they would resist a famine longer because of their fat reserves. In developed countries people no longer fear hunger... but just a couple of centuries ago this was quite a common occurence.

Well, since the explanation you are proposing seems to be contradicted by the readily available evidence, and you are continuing to propose it, and are now extending it to obese people as well, then yes I think you should provide evidence.

Disabling yourself is counterinuitive because it makes your daily life harder, and confers no benefit to compensate for that (unless you suffer from BIID). It's also irreversible.
There doesn't need to be any further explanation, if you are proposing one, it would be nice if you supported it.

 

[Luciana]

Well, since the explanation you are proposing seems to be contradicted by the readily available evidence,

Evidence? And that was...?

and you are continuing to propose it, and are now extending it to obese people as well, then yes I think you should provide evidence.

My claim regards the reaction people have with the idea of voluntary amputation - even if it's made as treatment for a mental disorder. Unless we run a scientific poll investing the reasons as to why people feel this gut reaction, I do not think we can either prove or disprove anything.

Disabling yourself is counterinuitive because it makes your daily life harder, and confers no benefit to compensate for that (unless you suffer from BIID). It's also irreversible.
There doesn't need to be any further explanation, if you are proposing one, it would be nice if you supported it.

Extreme obesity and pregnancy do disable people. But both are reversible, and pregnancy is all about survival of the species. Society does confer special treatment to pregnant women, but it's understood that's how it's meant to be.

Making daily life harder and no benefit... no, i don't think the gut reaction against amputation is because of that. To me, I assure you it's not. The fact is that I would feel much more vulnerable and helpless if I missed a limb - and not on a daily basis, because humans do adapt. That is, once I had both arms in a cast for two months, and I adapted just fine! I mean it in a deeper level.

 

[Guybrush Threepwood]

Evidence? And that was...?

In my first reply to you. Vast numbers of people are willing to reduce their disaster survival potential in other ways, ergo it's not a major concern for them. It's anecdotal I know, but it's there.

Extreme obesity and pregnancy do disable people. But both are reversible, and pregnancy is all about survival of the species. Society does confer special treatment to pregnant women, but it's understood that's how it's meant to be.

They are only reversible with surgery (I know in theory even severe obesity is reversible without, in practice not so much). I agree pregnancy is temporary, and there are extremely good reasons why women want to get pregnant, but it still reduces your disaster survival ability.

Making daily life harder and no benefit... no, i don't think the gut reaction against amputation is because of that. To me, I assure you it's not. The fact is that I would feel much more vulnerable and helpless if I missed a limb - and not on a daily basis, because humans do adapt. That is, once I had both arms in a cast for two months, and I adapted just fine! I mean it in a deeper level.

I can't argue with that, how you feel is how you feel. I just disagree with extrapolating that to everyone else without supporting evidence.
It's the opposite for me, I hike and cycle a lot, losing a limb would concern me because it would stop me doing the things I enjoy, not because of my lowered survival chances during the zombie apocalypse.

 

[Pup]

How about amputation of a brain part where the disorderly thought is stored, instead of amputating a limb, penis or vagina?

Other than the little detail that we don't know which part of the brain that would be, that sounds like a great solution.

Also, at least in the case of sex changes, I'm not sure what the person would think.

I'm male. Let's say in some futuristic world of medicine, my privates are cut off in an accident. Doctors tell me I have two choices: they can reconstruct me as a perfectly natural-looking female all over and fix my brain so I'll think I'm female, or leave me as a male with crippled privates. I know which I'd choose, without a doubt. Being "me" is more important than being physically perfect, and who I am is all wrapped up in my gender/sex.

But I'm not sure what decision transgender people would be most apt to make, if given a chance to have their brain "fixed," let alone people with BIID. It's an interesting question.

 

[PhantomWolf]

For me, that issue is as simple as the facts that transgender people tend to be extremely unhappy in the gender they are born with

I stopped reading here because you obviously have no clue. Gender is not defined by what you have between your legs. Trans people are not unhappy with the gender they were born with, they are born a different gender from what their physical body indicates they are. Their body conflicts with all the other things that determine gender. The second reason they are unhappy is that our society expects people to be the same as what is between their legs and casts shame and degradation on anyonhe that isn't. Some Trans are happy with a partial transistion. Just to be accepted socially as their gender despite their body not agreeing can be enough for some, no need to undergo srs. For others a full transistion is needed so that their body match their gender.

I had the same thought reading the transgender thread. People may truly believe that any part of their body is 'wrong'.

I feel I need to restate this. Transgender is not about a "belief" any more than you believe you are a woman (or a man.) It is not about what people believe, but a fundamental state of what they are. Saying that they believe that a part of them is wrong is like saying that some people believe that they are attracted to people the same sex as them. It is degrading and insulting. Please desist in doing this.

 

[PhantomWolf]

Other than the little detail that we don't know which part of the brain that would be, that sounds like a great solution.

Also, at least in the case of sex changes, I'm not sure what the person would think.

I'm male. Let's say in some futuristic world of medicine, my privates are cut off in an accident. Doctors tell me I have two choices: they can reconstruct me as a perfectly natural-looking female all over and fix my brain so I'll think I'm female, or leave me as a male with crippled privates. I know which I'd choose, without a doubt. Being "me" is more important than being physically perfect, and who I am is all wrapped up in my gender/sex.

But I'm not sure what decision transgender people would be most apt to make, if given a chance to have their brain "fixed," let alone people with BIID. It's an interesting question.

Other than a implied suggestion that trans people are broken and need fixing, I think that most Trans people if given such an option would jump at it, and their brain wouldn't need "fixing" to become the target gender, it already is their target gender.

 

[PhantomWolf]

How about amputation of a brain part where the disorderly thought is stored, instead of amputating a limb, penis or vagina?

How much of youir brain would we have to amputate before you stopped identifying as a male?

 

[Pup]

Other than a implied suggestion that trans people are broken and need fixing, I think that most Trans people if given such an option would jump at it, and their brain wouldn't need "fixing" to become the target gender, it already is their target gender.

Wait... You're saying that a transgender person who was born with a male brain and female body would jump at the chance to have their brain changed to match the female body, rather than continue to live their life as a male with messed-up private parts (which is sorta the situation they're in now, as I understand it, with the state of current surgery)?

That's not what I would have guessed. At least, I would have guessed it would be a difficult decision, with answers probably split.

 

[Wolfman]

PhantomWolf,

Your comments re: transgenders is quite interesting...but this thread is about BIID. I'd be curious as to how far you'd be willing to extend your arguments for transgenders, to those who suffer from BIID.

 

[Professor Yaffle]

I stopped reading here because you obviously have no clue.

My apologies, I misworded that in my OP. I meant to say that transgender people tend to be extremely unhappy with the sex of the body they were born with, but I muddled my terms because I was trying to get my head around other, related issues.

 

[CelticRose]

I have to wonder about the ethics of a society that will not allow someone who is in constant psychological distress to relieve that distress by means of surgery, yet will allow other people to have surgery just because they don't think they're pretty enough.

Basically, it all boils down to which body parts society thinks are acceptable to alter.

 

[sgtbaker]

I have to wonder about the ethics of a society that will not allow someone who is in constant psychological distress to relieve that distress by means of surgery, yet will allow other people to have surgery just because they don't think they're pretty enough.

Basically, it all boils down to which body parts society thinks are acceptable to alter.

I kind of feel that way but then getting liposuction or rhinoplasty doesn't disable you; losing limbs, eyes, hearing, or the use of your entire lower body does. Doctors take an oath to do no harm, reducing an able body to a state of disability is, by all definition, harm.

The other part of that is, cosmetic surgery does not need a doctor's order, limb removal does. A doctor would never order liposuction as a treatment for severe anorexia or rhinoplasty as a treatment for someone with severe dysmorphia because it would be endulging the patient's delusion.

 

[CelticRose]

I kind of feel that way but then getting liposuction or rhinoplasty doesn't disable you; losing limbs, eyes, hearing, or the use of your entire lower body does. Doctors take an oath to do no harm, reducing an able body to a state of disability is, by all definition, harm.

I'd say that anyone who is feeling such psychological distress that they are willing to inflict incredibly painful injuries on themselves in order to get rid of the offending body part is already disabled.

Also, I don't think that doctors take an oath to do no harm. At least, the modern version of the Hippocratic Oath doesn't contain that phrase. http://en.wikipedia.org/wiki/Hippocratic_Oath#Modern_version

The other part of that is, cosmetic surgery does not need a doctor's order, limb removal does. A doctor would never order liposuction as a treatment for severe anorexia or rhinoplasty as a treatment for someone with severe dysmorphia because it would be endulging the patient's delusion.

Yet someone with those disorders could easily get those surgeries by going to a plastic surgeon and not disclosing their disorder. As long as they have the money to pay for the surgery, they'll be able to find a doctor willing to do it.

 

[Wolfman]

Doctors take an oath to do no harm, reducing an able body to a state of disability is, by all definition, harm.

I agree, and I disagree.

This isn't just an issue of physical health...it is an issue of psychological health, too. Give me a choice between A) having a healthy body, but spending my life in depression, or B) having only one let, but no depression...and I honestly would likely choose the latter. Sometimes psychological suffering can be much worse than physical disabilities.

So to me, the question is how bad the suffering of those with BIID is (and certainly in at least some cases, it seems to be quite significant), and following on that, whether the desired surgery will decrease or eliminate that psychological suffering. And at least according to the (admittedly limited) research that I've read on this, there does seem to be significant, permanent psychological relief for those who are successful in achieving whatever physical state it is they are pursuing.

In cases where the psychological suffering is significant, and surgery will significantly decrease or eliminate it...then I'd personally say go for it. The physical disability they'll face will be far less debilitating to them than the psychological pain they are currently suffering.

 

[sgtbaker]

I'd say that anyone who is feeling such psychological distress that they are willing to inflict incredibly painful injuries on themselves in order to get rid of the offending body part is already disabled.

Yes but if you see a young teen literally starving themselves to death (willing to go to extremes) to lose body fat, what would be your response? Would you give them diet pills, offer to help them get liposuction, or take them to a psychiatrist to get treatment for the disorder?

Also, I don't think that doctors take an oath to do no harm. At least, the modern version of the Hippocratic Oath doesn't contain that phrase. http://en.wikipedia.org/wiki/Hippocratic_Oath#Modern_version

They Hippocratic Oath is a vow to practice medicine ethically.

The concept of non-maleficence is embodied by the phrase, "first, do no harm," or the Latin, primum non nocere. Many consider that should be the main or primary consideration (hence primum): that it is more important not to harm your patient, than to do them good. This is partly because enthusiastic practitioners are prone to using treatments that they believe will do good, without first having evaluated them adequately to ensure they do no (or only acceptable levels of) harm.

http://en.wikipedia.org/wiki/Medical_ethics#Non-Maleficence

Yet someone with those disorders could easily get those surgeries by going to a plastic surgeon and not disclosing their disorder. As long as they have the money to pay for the surgery, they'll be able to find a doctor willing to do it

Yes, and the tragedy of it all is that a person with severe dysmorphia will likely find something else to hate about their appearance, not that BIID sufferers are unable to have a limb removed for no medical reason; especially considering the root of the problem seems to lie in the brain, not the limb.

 

[Wolfman]

Yes, and the tragedy of it all is that a person with severe dysmorphia will likely find something else to hate about their appearance, not that BIID sufferers are unable to have a limb removed for no medical reason; especially considering the root of the problem seems to lie in the brain, not the limb.

That was what I thought, too...but in doing more research on it, it appears to not necessarily be the case. A number of those who were successful in achieving whatever state they wanted (surgically, or on their own) subsequently suffered no further symptoms, and were effectively 'cured'.

 

[PhantomWolf]

Wait... You're saying that a transgender person who was born with a male brain and female body would jump at the chance to have their brain changed to match the female body, rather than continue to live their life as a male with messed-up private parts (which is sorta the situation they're in now, as I understand it, with the state of current surgery)?

That's not what I would have guessed. At least, I would have guessed it would be a difficult decision, with answers probably split.

Perhaps I read it wrong, but it appeared to me that you were asking what a TG person would do if doctors could create a perfect body for them of the other gender, not what they would do if they could get their brain "fixed". So if it was a choice of brain or body, I'd say most TGs would opt for body. As you noted, changing the gender of our brain is to change who we are on a fundamental level. Sorry for any confusion there.

 

[PhantomWolf]

PhantomWolf,

Your comments re: transgenders is quite interesting...but this thread is about BIID. I'd be curious as to how far you'd be willing to extend your arguments for transgenders, to those who suffer from BIID.

I think that they are quite different things. Being TG does just mean you don't like having the wrong genitalia, or that you feel the genitalia you do have isn't you're, or doesn't belong. It's a lot deeper than that, it is something about your whole being. Even if we just concentrate on the physical, it goes further than just what is between your legs.

It's hard to explain to someone that doesn't have it because you don't have a reference to work with. You are unlikely to understand what it is like to see someone else and be jealous of them because they have a body that could transition well, or just because they are a cis-female and so born without the issues you have if you haven't been there. It's not like BIID where the brain is not recognising part of the body. We're talking a person's personality, mannerisms and more, the entire being that makes up who they are. These don't differ between a person with a leg and without one, they do between genders.