University of Aberdeen Medical School, Mealmarket Exchange, Mealmarket Street, Aberdeen AB24-5SW, Scotland.
J Med Ethics. 2010 Feb;36(2):75-8. doi: 10.1136/jme.2009.031070.
Apotemnophilia is a condition that causes those who have it to not feel "correct" in their own bodies. As a result, an intense obsession develops with removing the limb; this obsession hinders tremendously the patients' social behaviour and societal integration. These patients, in some respects resembling transgendered individuals, feel that the body part (limb) in question is simply "not a part of themselves", causing them to feel uncomfortable in their own bodies. Whether amputations should be performed on apotemnophiles or not is a question that poses a significant medical ethical dilemma. It is argued that observing an apotemnophile's request for amputation is the ethical action. The major arguments opposing such amputations and supporting such amputations are examined and critically analysed with regard to ethical principles-namely, patient autonomy, beneficence, non-maleficence and justice with regard to every person's "right to happiness". Finally, a discourse on how the accepted notion of harm does not apply to apotemnophilia is developed to justify the position that amputation is indeed medically the ethical choice.
自截癖是一种会使患者对自己的身体感到“不正确”的病症。因此，患者会产生强烈的移除肢体的冲动；这种冲动极大地阻碍了患者的社交行为和社会融合。这些患者在某些方面类似于跨性别者，他们觉得有问题的肢体“根本不属于自己”，导致他们在自己的身体里感到不舒服。是否应该对自截癖患者进行截肢是一个引发重大医学伦理困境的问题。有人认为，观察自截癖患者的截肢请求是符合伦理的做法。本文对反对和支持这种截肢的主要论点进行了审查和批判性分析，涉及伦理原则，即患者自主权、善行、不伤害和每个人的“幸福权利”的公正。最后，本文还探讨了为什么公认的伤害概念不适用于自截癖，从而证明了截肢确实是医学上的伦理选择。
