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Author Topic:   Where is the line between a disorder and else?
nwr
Member
Posts: 6408
From: Geneva, Illinois
Joined: 08-08-2005
Member Rating: 5.1


(1)
Message 46 of 77 (704914)
08-20-2013 9:09 AM
Reply to: Message 41 by Rahvin
08-19-2013 9:07 PM


So tie this all back to the topic: If a man suffers from BIID and loathes his left arm and wishes it removed, is he crazy? Should amputation be considered a viable treatment, or should it not be an option at all? How do the concepts of "harm," life expectancy, self-harming choices, personal choice, self-determination, and quality of life align in such a case?
What comes to mind, for me, in this discussion is the question of the right to die; the right of a terminally ill person to die on his own terms and the right to assisted suicide in such cases.
Some of the arguments against allowing the BIID person to amputate have been presented in a way that would deny a terminally ill person the right to die.
Much like Rahvin, I don't have a settled position on BIID. But I am troubled by some of the arguments that have been given in this thread.

Fundamentalism - the anti-American, anti-Christian branch of American Christianity

This message is a reply to:
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Replies to this message:
 Message 49 by NoNukes, posted 08-20-2013 1:13 PM nwr has replied

  
New Cat's Eye
Inactive Member


Message 47 of 77 (704915)
08-20-2013 9:36 AM
Reply to: Message 43 by yenmor
08-19-2013 11:44 PM


I don't just fear. I've already been like black folks in this regard.
A number of years ago, I met this young man. At the time, he had just come back from a 6 year tour in Iraq and was just trying to find his place in the gay community. I went over and introduced myself to him and we began to see each other. Then we started dating. Then I asked him to move in with me and he agreed.
Well, he started telling me that the reason he joined the army was because he didn't know where his place was here back home. He thought he was gay. Well, it turned out that by having a relationship with me he was getting closer to what he was, but not quite. He started dressing in women's clothing and wearing makeup. So, here I was watching my partner transition into the opposite sex. Let just say I wasn't very tolerant.
See how that works? Despite the fact that I had been prejudiced against by society at large for all my life, I was just as intolerant of my partner's "condition" (for lack of a better word).
I don't think so. Ask yourself this: Would you have reacted the same way if you knew they were trans from the beginning?
It sounds to me like it was the unexpected change, and not the condition, that you couldn't tolerate. And that's understandable.

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 Message 43 by yenmor, posted 08-19-2013 11:44 PM yenmor has not replied

  
Taq
Member
Posts: 9970
Joined: 03-06-2009
Member Rating: 5.6


(1)
Message 48 of 77 (704917)
08-20-2013 12:52 PM
Reply to: Message 19 by yenmor
08-16-2013 11:52 PM


According to some people who have confronted my partner and I, we are hurting
-our families
-our society by advocating the extinction of the human race
-teenage girls because homosexuality leads to teenage pregnancy
-everyone around us because our relationship grosses them out
-ourselves because we'll never have biological children, get aids, etc.
They are in the wrong. Offending someone's sensibilities is not doing them harm.

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NoNukes
Inactive Member


Message 49 of 77 (704919)
08-20-2013 1:13 PM
Reply to: Message 46 by nwr
08-20-2013 9:09 AM


Some of the arguments against allowing the BIID person to amputate have been presented in a way that would deny a terminally ill person the right to die.
To which arguments are you referring.

Under a government which imprisons any unjustly, the true place for a just man is also in prison. Thoreau: Civil Disobedience (1846)
I believe that a scientist looking at nonscientific problems is just as dumb as the next guy.
Richard P. Feynman
If there is no struggle, there is no progress. Those who profess to favor freedom, and deprecate agitation, are men who want crops without plowing up the ground, they want rain without thunder and lightning. Frederick Douglass

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 Message 46 by nwr, posted 08-20-2013 9:09 AM nwr has replied

Replies to this message:
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NoNukes
Inactive Member


Message 50 of 77 (704921)
08-20-2013 1:44 PM
Reply to: Message 48 by Taq
08-20-2013 12:52 PM


Taq writes:
They are in the wrong. Offending someone's sensibilities is not doing them harm.
I fully agree with Taq. I question why you don't see this yourself.
yenmor writes:
Who are we to say their arguments are invalid but ours are not?
A loaf of bread has more spine than you show here. Are you really advocating for the extinction of the human race? Are you truly unable to see that argument as invalid.

Under a government which imprisons any unjustly, the true place for a just man is also in prison. Thoreau: Civil Disobedience (1846)
I believe that a scientist looking at nonscientific problems is just as dumb as the next guy.
Richard P. Feynman
If there is no struggle, there is no progress. Those who profess to favor freedom, and deprecate agitation, are men who want crops without plowing up the ground, they want rain without thunder and lightning. Frederick Douglass

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Replies to this message:
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Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


Message 51 of 77 (704922)
08-20-2013 1:45 PM
Reply to: Message 44 by NoNukes
08-20-2013 5:40 AM


In the case of BIID, yes the patient might well chew his own leg off, badger style.
I remember watching one of those "Crazy ER Stories" shows that included a dramatized reenactment of a man who cut off his own hand because he suffered from BIID. In this case, the doctor faces the ethical dilemma of whether he should reattach the hand, and whether he had the right to do so against the will of his patient, who threatened to cut it off again if it were reattached.
The doctor chose to accede to the wishes of his patient, and his patient's right to refuse medical treatment.
But what we are asking about is whether it would be ethical to refuse to amputate his leg rather than to try to give him psychiatric treatment.
In a way, yes. More generally, we're asking about the limits of self-determinism, body integrity rights, and mental fitness. If we refuse to cut off a man's leg, we're essentially saying "you are not mentally fit to make this decision."
The question is where that line gets drawn, and how we know where to draw it - how do we know when a person is fit to make such a decision, and how do we know a person is unfit? It cannot be simply "I understand wanting to do that," because we routinely allow people to have things done to their bodies that others might find incomprehensible (extreme body modification, for example). Why is a person who wants to have their tongue cut into halves, or a person who wants to have extreme scarrification, or a person who wants to be branded, not mentally ill, but a person who wants to have his pinkie finger removed mentally ill?
What immediately comes to mind is the mindset of the person seeking the procedure - why they want an arm removed. From my understanding, a person suffering from BIID actually believes that their limb is harming them. This is a false belief - a delusion. Is that how we should draw the line? If a person wants to do something due to a delusional belief, can we say they are unfit to make such a decision, label their delusion a disorder, and offer psychiatric treatment as their only option other than extremely dangerous non-medical self-mutilation?
Would that mean that if a person wants to have an amputation as a form of extreme body modification, fully understanding that the procedure is not in any way necessary, that the limb in question is not harmful, that the procedure carries risk in and of itself, and the consequences afterward, that we should allow that person to receive the amputation? With no delusional belief motivating the desire for amputation, does the argument of mental fitness no longer apply?
What would this mean for transgendered individuals? I personally wouldn't characterize their gender identity as delusional - but I can see such an argument being made very easily, that the reality is the chromosomal content of their cells and that their identity is a delusion. All it takes is prioritizing the physical body over the mind.

The human understanding when it has once adopted an opinion (either as being the received opinion or as being agreeable to itself) draws all things else to support and agree with it. - Francis Bacon
"There are two novels that can change a bookish fourteen-year old's life: The Lord of the Rings and Atlas Shrugged. One is a childish fantasy that often engenders a lifelong obsession with its unbelievable heroes, leading to an emotionally stunted, socially crippled adulthood, unable to deal with the real world. The other, of course, involves orcs." - John Rogers
A world that can be explained even with bad reasons is a familiar world. But, on the other hand, in a universe suddenly divested of illusions and lights, man feels an alien, a stranger. His exile is without remedy since he is deprived of the memory of a lost home or the hope of a promised land. This divorce between man and his life, the actor and his setting, is properly the feeling of absurdity. — Albert Camus
"...the pious hope that by combining numerous little turds of variously tainted data, one can obtain a valuable result; but in fact, the outcome is merely a larger than average pile of shit." - Barash, David 1995...
"Many that live deserve death. And some die that deserve life. Can you give it to them? Then be not too eager to deal out death in the name of justice, fearing for your own safety. Even the wise cannot see all ends." - Gandalf, J. R. R. Tolkien: The Lord Of the Rings
Nihil supernum

This message is a reply to:
 Message 44 by NoNukes, posted 08-20-2013 5:40 AM NoNukes has replied

Replies to this message:
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ringo
Member (Idle past 411 days)
Posts: 20940
From: frozen wasteland
Joined: 03-23-2005


(1)
Message 52 of 77 (704923)
08-20-2013 1:51 PM
Reply to: Message 43 by yenmor
08-19-2013 11:44 PM


yenmor writes:
Let just say I wasn't very tolerant.
On the bright side, you can recognize intolerance in yourself. That's the first step toward reducing your own intolerance.
A lot of people would just say, "How dare you suggest that I'm intolerant?"

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 Message 43 by yenmor, posted 08-19-2013 11:44 PM yenmor has not replied

  
Perdition
Member (Idle past 3237 days)
Posts: 1593
From: Wisconsin
Joined: 05-15-2003


(1)
Message 53 of 77 (704925)
08-20-2013 2:21 PM
Reply to: Message 51 by Rahvin
08-20-2013 1:45 PM


Harm to others
In a way, yes. More generally, we're asking about the limits of self-determinism, body integrity rights, and mental fitness. If we refuse to cut off a man's leg, we're essentially saying "you are not mentally fit to make this decision."
I'm very much a believer that people should be free to do whatever they want so long as it doesn't harm anyone else. The trouble I run into is defining "harm to someone else."
For instance, in Wisconsin, we have two completely at odds laws. On one hand, it is illegal to drive without a seatbelt, on the other hand it is perfectly legal to ride a motorcycle without a helmet. I tend to side with the people who want to be able to choose (poorly) to drive without a seatbelt. I would never make that choice, but I don't think it should be codified in law.
However, if that person drives without a seatbelt, crashes and gets hurt, who is really being harmed. The person driving, obviously, but it was their choice, so "oh well". But then, if they have family, that family is distraught, not to mention perhaps financially dependent on them (or even just paying for their medical bills). Even if the person is completely familyless, they're now in surgery in the ER, taking the spot of someone else who may need surgery but not quite as urgently, or who merely got injured a little bit after the first person.
In the case of BIID, I'd like to agree that if they truly want to amputate an appendage, and are mentally competent enough to make that decision, then let them. But then again, if they have a family who depends on them for financial support, or if they'll be thrown onto disability and now taking resources from all tax payers (or others who could use the assistance) based on a choice rather than an accident, I'm less inclined to their side.
I guess I'd say, if they can be treated and brought closer to the "mainstream" then that should be the first choice.
Would that mean that if a person wants to have an amputation as a form of extreme body modification, fully understanding that the procedure is not in any way necessary, that the limb in question is not harmful, that the procedure carries risk in and of itself, and the consequences afterward, that we should allow that person to receive the amputation? With no delusional belief motivating the desire for amputation, does the argument of mental fitness no longer apply?
The thing to look at is again, harm to others. Getting piercings, tattoos, scars, etc doesn't stop a person from being able to work. There may be some positions that won't allow a lot of tattoos or piercings, but that's actually becoming more and more acceptable in many work environments. What removing a part of your body does is remove certain occupations from being a consideration. Without arms, you can't carry things, without legs, you can't do many jobs, etc.
It might come down to how "extreme" the removal will be. Removing a pinky probably won't have much of an impact, and if ti will really improve their quality of life, then I say "Off with the finger." If they want to remove their leg or their arm, we need to see what the plan is for after the surgery. If they have a job that doesn't require that appendage, and they'll be able to continue to take car eof their obligations, then again, if it will actually increase their enjoyment of life, let them.
Sorry if this was a bit of a ramble, but I'm trying to figure this out myself.

This message is a reply to:
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Replies to this message:
 Message 56 by jar, posted 08-20-2013 3:09 PM Perdition has replied

  
Theodoric
Member
Posts: 9076
From: Northwest, WI, USA
Joined: 08-15-2005
Member Rating: 3.7


Message 54 of 77 (704926)
08-20-2013 2:25 PM
Reply to: Message 50 by NoNukes
08-20-2013 1:44 PM


I still maintain he is nothing more than a troll.

Facts don't lie or have an agenda. Facts are just facts
"God did it" is not an argument. It is an excuse for intellectual laziness.

This message is a reply to:
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NoNukes
Inactive Member


Message 55 of 77 (704928)
08-20-2013 2:40 PM
Reply to: Message 51 by Rahvin
08-20-2013 1:45 PM


What would this mean for transgendered individuals? I personally wouldn't characterize their gender identity as delusional - but I can see such an argument being made very easily,
I would not characterize their gender identity as delusional either. On the other hand I do generally characterize people who feel the need to cut themselves as needing treatment rather than freer access to sharp instruments.
If we refuse to cut off a man's leg, we're essentially saying "you are not mentally fit to make this decision."
Yes. that's right. And in my view it is often (but not always) possible to determine when to "draw the line" as you say. And doing so does not require prioritizing body over mind.
Why is a person who wants to have their tongue cut into halves, or a person who wants to have extreme scarrification, or a person who wants to be branded, not mentally ill, but a person who wants to have his pinkie finger removed mentally ill?
Who says those people aren't mentally ill? Some of them might well be.

Under a government which imprisons any unjustly, the true place for a just man is also in prison. Thoreau: Civil Disobedience (1846)
I believe that a scientist looking at nonscientific problems is just as dumb as the next guy.
Richard P. Feynman
If there is no struggle, there is no progress. Those who profess to favor freedom, and deprecate agitation, are men who want crops without plowing up the ground, they want rain without thunder and lightning. Frederick Douglass

This message is a reply to:
 Message 51 by Rahvin, posted 08-20-2013 1:45 PM Rahvin has not replied

  
jar
Member (Idle past 393 days)
Posts: 34026
From: Texas!!
Joined: 04-20-2004


Message 56 of 77 (704929)
08-20-2013 3:09 PM
Reply to: Message 53 by Perdition
08-20-2013 2:21 PM


Re: Harm to others
For instance, in Wisconsin, we have two completely at odds laws. On one hand, it is illegal to drive without a seatbelt, on the other hand it is perfectly legal to ride a motorcycle without a helmet. I tend to side with the people who want to be able to choose (poorly) to drive without a seatbelt. I would never make that choice, but I don't think it should be codified in law.
I almost totally agree with that position and think it is nearly perfect. The only change I'd suggest is that someone who rides a motorcycle without a helmet should not be eligible for public medical care in the case of an accident where not wearing a helmet caused damage.
The seatbelt was developed not for safety but rather to anchor the driver behind the controls, steering, braking, accelerating. When a driver does not wear a seatbelt that driver is NOT capable of maintaining position and control during violent evasive maneuvers. Passengers in a car not wearing a seatbelt become just another projectile that can also interfere with the driver avoiding an accident.
The person in another vehicle who is NOT wearing a seatbelt is a threat to people not in that car.
The person on a motorcycle not wearing a helmet though is a threat only to himself.
I do not think it is reasonable though to expect the public to subsidize medical care for someone too dumb to wear a helmet.

Anyone so limited that they can only spell a word one way is severely handicapped!

This message is a reply to:
 Message 53 by Perdition, posted 08-20-2013 2:21 PM Perdition has replied

Replies to this message:
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 Message 61 by Rahvin, posted 08-20-2013 6:16 PM jar has replied

  
Perdition
Member (Idle past 3237 days)
Posts: 1593
From: Wisconsin
Joined: 05-15-2003


(2)
Message 57 of 77 (704931)
08-20-2013 4:26 PM
Reply to: Message 56 by jar
08-20-2013 3:09 PM


Re: Harm to others
The seatbelt was developed not for safety but rather to anchor the driver behind the controls, steering, braking, accelerating. When a driver does not wear a seatbelt that driver is NOT capable of maintaining position and control during violent evasive maneuvers. Passengers in a car not wearing a seatbelt become just another projectile that can also interfere with the driver avoiding an accident.
That may be true, though I would say that in the event where I would be thrown from my seat were I not wearing a seatbelt, I'm probably not going to be in much control regardless.
The person on a motorcycle not wearing a helmet though is a threat only to himself.
Only compared to a driver with a helmet. A motorcycle driver could be thrown into oncoming traffic or walkers on the sidewalk, but I agree, the helmet or lack thereof won't make much difference to those people.
I do not think it is reasonable though to expect the public to subsidize medical care for someone too **** to wear a helmet.
I'm torn on this. I think stupid idiots deserve as much healthcare as the rest of us, but I can understand the thought that they need to live (or not) with the consequences of their actions. But again, we're left with the fact that they may not be the only victims in this case. They may have family dependent on them, and now you're depriving them of somene who may be able to provide for the family in the future,given care and treatment, but who won't if left untreated.
I guess we could insist that they pay their medical bills, regardless of their insurance status, garnishing their pay and such to ensure full repayment. At the moment, not paying your medical bills has nearly no detrimental effect on you or your credit rating.

This message is a reply to:
 Message 56 by jar, posted 08-20-2013 3:09 PM jar has replied

Replies to this message:
 Message 58 by jar, posted 08-20-2013 4:43 PM Perdition has replied

  
jar
Member (Idle past 393 days)
Posts: 34026
From: Texas!!
Joined: 04-20-2004


Message 58 of 77 (704932)
08-20-2013 4:43 PM
Reply to: Message 57 by Perdition
08-20-2013 4:26 PM


Re: Harm to others
That may be true, though I would say that in the event where I would be thrown from my seat were I not wearing a seatbelt, I'm probably not going to be in much control regardless.
It's not just being throw from your seat but rather that your arms, hands and feet are free to be used to avoid an accident instead of being used to maintain your position.
Believe me, it is amazing how much a driver can do if strapped in place.
Of course, at least in the US we don't teach accident avoidance or even defensive driving.
But again, we're left with the fact that they may not be the only victims in this case. They may have family dependent on them, and now you're depriving them of somene who may be able to provide for the family in the future,given care and treatment, but who won't if left untreated.
Correct. But if the wife and kids know that if Dad gets on a motorcycle without a helmet and gets in an accident they will be left without support maybe they may tell Dad it's helmet and highway or just highway.

Anyone so limited that they can only spell a word one way is severely handicapped!

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 Message 57 by Perdition, posted 08-20-2013 4:26 PM Perdition has replied

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nwr
Member
Posts: 6408
From: Geneva, Illinois
Joined: 08-08-2005
Member Rating: 5.1


Message 59 of 77 (704933)
08-20-2013 5:08 PM
Reply to: Message 49 by NoNukes
08-20-2013 1:13 PM


To which arguments are you referring.
I was thinking of comments such as that in Message 14. But perhaps I was reading more into that than intended.

Fundamentalism - the anti-American, anti-Christian branch of American Christianity

This message is a reply to:
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Perdition
Member (Idle past 3237 days)
Posts: 1593
From: Wisconsin
Joined: 05-15-2003


Message 60 of 77 (704936)
08-20-2013 5:24 PM
Reply to: Message 58 by jar
08-20-2013 4:43 PM


Re: Harm to others
Believe me, it is amazing how much a driver can do if strapped in place.
Of course, at least in the US we don't teach accident avoidance or even defensive driving.
And that's what I was getting at. If I knew what to do in those situations, then having the stabilization of a seatbelt would be very beneficial. But seeing as how I don't, the stabilization doesn't help me much if I've pressed the brake as hard as I can and thrown my hands over my eyes.
Not that I would do that, but there are a lot of drivers who would.
Correct. But if the wife and kids know that if Dad gets on a motorcycle without a helmet and gets in an accident they will be left without support maybe they may tell Dad it's helmet and highway or just highway.
Unfortunately, they don't. If they're dependent on Dad for things like shelter, food, electricity, clothing, etc, then what can they threaten him with, leaving and letting him keep more money?
Besides, people tend to have an overinflated sense of their own ability. They figure that people who crash motorcycles just weren't as good as them, since they've never crashed one, so why bother with a helmet that won't be needed?

This message is a reply to:
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