title: Exploring ethical justification for self-demand amputation.
abstract: Self-demand amputees are persons who need to have one or more healthy limbs or digits amputated to fit the way they see themselves. They want to rid themselves of a limb that they believe does not belong to their body-identity. The obsessive desire to have appendages surgically removed to fit an alternative body-image is medically and ethically controversial. My purpose in this paper is to provide a number of normative and professional ethical perspectives on whether or not it is possible to justify surgery for self-demand amputees. In doing so I proceed dialogically, moving between empirical context and normative theory, revealing the taken for granted normative assumptions (what I call the natural attitude--a technical term borrowed from phenomenology) that provide ethical limits to justifying the treatment of self-demand amputees. While I critically examine both Kantian responses against as well as Utilitarian responses for amputation on demand, I conclude that neither normative tradition can fully incorporate an understanding of what it is like to be a self-demand amputee. Since neither theory can justify the apparent non-rational desire of amputation on demand, ethical justification, I argue, falls short of the recognition that there may be a problem. To end, I introduce a meta-ethical idea, "the struggle for recognition," opening up the theoretical possibility of a hermeneutics of recognition before ethical justification that may be more sensitive to the problem of radical embodied difference exemplified by self-demand amputees.
authors.affiliation: Institute for the Environment, Philosophy and Public Policy, Furness College, Lancaster University, Lancaster, UK.
authors.forename: Floris
authors.initials: F
authors.lastname: Tomasini
mesh_terms: D000671:Amputation, Surgical / Q000941:ethics* / Q000523:psychology*; D001828:Body Image; D017558:Elective Surgical Procedures / Q000941:ethics* / Q000523:psychology*; D026689:Ethical Analysis; D006801:Humans; D016743:Mental Competency; D001523:Mental Disorders; D010684:Philosophy; D016079:Refusal to Treat / Q000941:ethics