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Author Topic:   Where is the line between a disorder and else?
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


Message 12 of 77 (704775)
08-16-2013 4:23 PM
Reply to: Message 4 by jar
08-16-2013 10:14 AM


Re: Consistent ?
We can always make up a justification for what we want, but consistency often leads to very, very ****** ends
And inconsistency doesn't?
Consistency is not the problem. The rules being consistently adhered to are. A consistent valuation of human life is a good thing and disallows racism and other similar problems. Inconsistent, arbitrary determinations on who or what carries moral worth is what leads to making arbitrary exceptions over things like skin color.

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 4 by jar, posted 08-16-2013 10:14 AM jar has replied

Replies to this message:
 Message 13 by jar, posted 08-16-2013 4:39 PM Rahvin has replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


Message 15 of 77 (704779)
08-16-2013 7:09 PM
Reply to: Message 13 by jar
08-16-2013 4:39 PM


Re: Consistent ?
Sorry but that is simply empty words and of no use or value. A great example is that during slavery there was a consistent valuation of human life. Slaves were not humans and just property.
How absurd. The problem was not the consistent application, but the exception made. It's like you're assaulting a logically sound argument, when the real problem is one of its required assumptions. Obviously a consistent valuation of human life is ineffective if actual humans are considered not-human - but that's not a flaw with the principle of consistency. Quite the opposite - it means there is another rule, that which determines who is and who is not human, which was not being followed consistently, and that was the problem.
Human morality has advanced in large part by establishing basic ethical rules and extrapolating consistently from them. People realized racism was bad because it involves treating some people differently, being inconsistent in the value of human beings because of arbitrary differences like skin color. The expansion of our circles of ethical concern to make our treatment of others to be more consistent with how we ourselves like to be treated.
"Thinking beyond rules" is just a way of saying "I'll go with whatever I feel at the time."
Rather, we should be analyzing the rules we make, and deciding whether those rules should be kept or changed, or if we're adhering to them consistently.

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 13 by jar, posted 08-16-2013 4:39 PM jar has replied

Replies to this message:
 Message 16 by jar, posted 08-16-2013 7:33 PM Rahvin has not replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


(1)
Message 26 of 77 (704870)
08-19-2013 3:58 PM
Reply to: Message 25 by yenmor
08-19-2013 3:05 PM


Logically, I can't find a reason to tell someone who wants to amputate a healthy limb because they "feel like it" without that reason coming back to bite me in the ass. But my common sense is screaming at me telling me there's something seriously wrong with that picture.
Your "common sense" is driven by your sense of empathy - you're placing yourself in the shoes of another, and trying to understand how they'd feel. The problem is that your internal goals are different - you each prioritize personal body integrity differently. When you try to empathize, your brain says "but I don't want to cut off my arm, and neither can I think of a situation where I would." This mismatch is essentially what causes us to think others are "crazy" - attempting to understand a personally incomprehensible position held by another.
When we empathize, we're basically trying to simulate what another person feels using our own brains. When I empathize with an angry person, I trigger the "anger" circuitry in my own brain, and whatever I feel is what I simulate the angry person to be feeling. That usually serves us pretty well - human brains are very similar. But if I try to simulate a desire that I'd be extremely unlikely to ever hold under just about any circumstance, it doesn't work.
So try empathizing based on a different trigger. Stop thinking about the specific action the person wants to take with their own body, and start thinking about the person's ability to decide for him/herself what happens to his/her body. You and I can make decisions on whether to accept medical treatment, or to seek it, and our personal body integrity is protected by law - you cannot legally force someone to have a medical procedure.
Instead of trying to empathize based on the trigger of limb removal, imagine how you would feel if someone told you you couldn't get a tattoo or piercing, or that you had to undergo a medical procedure you don't consent to.
I find it much easier to empathize from that angle, and the decision becomes more clear. I'd still advise a requirement that a person who desires amputation receive counseling to ensure they have fully thought through what they want to happen and all of the consequences...but I don't see it as particularly different from the plight of a transgendered person.
I think it's interesting that a large number of people seem to be responding without actually explaining the reasoning behind their positions. Some are even saying "I have no problem making an arbitrary or inconsistent decision in this case," meaning they know that they're using some different criteria in this case from other decisions in similar cases, but they don't seem to know what those criteria are. It reeks of arguing from the gut - making an argument that one doesn't even understand oneself for reasons one cannot identify. So far as I can tell, nobody in this thread has identified a reason that a person who wants a limb removed is "crazy" other than that the individual responder says so.

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 25 by yenmor, posted 08-19-2013 3:05 PM yenmor has not replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


Message 30 of 77 (704883)
08-19-2013 6:16 PM
Reply to: Message 29 by NoNukes
08-19-2013 5:46 PM


As best as I can understand it, BIID is a disorder and amputation does harm the person.
Define "harm."
If one were to ask a person with BIID what he/she thought, I doubt they would agree that removing the limb would "harm" them. In fact, I expect that they'd argue that the limb itself is "harming" them. Certainly their quality of life with the limb is lower than what they expect from a life without the limb.
Let's be more pointed: explain the difference between a person who identifies as female and wants to alter her body so that it matches her internal identity, even though that means hormones and surgery and tissue removal, and another person who feels "wrong" about their left arm, feels oppressed and ill and just not right every hour of every day, and in order to remove that feeling is willing to remove their left arm, even though that means surgery and the removal of tissue and the ability to hold two items at once and so on.
How are these two people substantially different? Please be specific. Is surgery "harm" in one case, both cases, or neither case? Why? Please be specific. Is one, both, or neither individual "crazy?" Why? Please be specific.
Is it any business of yours what another person wants to do with their own body, being fully cognizant of the consequences of their actions? If so, why? Please be specific.

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 29 by NoNukes, posted 08-19-2013 5:46 PM NoNukes has replied

Replies to this message:
 Message 31 by jar, posted 08-19-2013 6:19 PM Rahvin has replied
 Message 38 by NoNukes, posted 08-19-2013 8:07 PM Rahvin has replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


Message 32 of 77 (704885)
08-19-2013 6:23 PM
Reply to: Message 31 by jar
08-19-2013 6:19 PM


Re: No right answer, many right answers
And it is examples like you post that demand inconsistency. Each case must be treated as an individual unique case and no one answer fits all.
And so you claim to "know" when you should treat an example as an exception, and yet you cannot define why.
How absurd.
There is some criteria you're using to decide who is and is not crazy, even if you're only applying it at the individual case level and refusing to be sufficiently introspective to figure out what the actual criteria are.

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 31 by jar, posted 08-19-2013 6:19 PM jar has replied

Replies to this message:
 Message 33 by jar, posted 08-19-2013 6:50 PM Rahvin has replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


Message 34 of 77 (704888)
08-19-2013 7:04 PM
Reply to: Message 33 by jar
08-19-2013 6:50 PM


Re: No right answer, many right answers
What I am saying is that each case is unique and unless a whole lot more information is available I cannot possibly make any ruling.
Trying to be consistent without full details is just plain ******.
So you acknowledge that there are criteria you're using, you simply throw up the defense that "it's too complicated and I don't know enough" as an obfuscation instead of even attempting to explain what those criteria are.
It's a hypothetical situation, jar. Ask for any specific details and I;m sure we can collectively fantasize responses. But the fact remains that there is some reason, in the final instance, that will make you say "this person is crazy," or "this person is not crazy."
Would you care to share what those reasons might be, and thereby contribute to the thread?

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 33 by jar, posted 08-19-2013 6:50 PM jar has replied

Replies to this message:
 Message 35 by jar, posted 08-19-2013 7:36 PM Rahvin has replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


Message 36 of 77 (704890)
08-19-2013 7:47 PM
Reply to: Message 35 by jar
08-19-2013 7:36 PM


Re: No right answer, many right answers
I'm saying only a fool would say that consistency is required or desirable.
As you say, you can make up any shit example you want.
Again, I can't say what would lead to a conclusion of "this person is crazy" or "this person is not crazy" that could be anything but made up bullshit.
How fortunate for any hypothetical patients of yours, then, that you are not in fact a psychiatrist, given that you are apparently incapable of discerning real mental disorder from sane but alien choice beyond the determination of your mercurial and arbitrary gut.
Again, I can't say what would lead to a conclusion of "this person is crazy" or "this person is not crazy" that could be anything but made up bullshit.
Indeed, "made up bullshit" is exactly the way I would describe your approach toward drawing the line between disorder and not-disorder - devoid of thought, containing only what knee-jerk emotional reflex occurs to you in the moment. One would expect that you could interview two individuals who provide identical responses in all ways, and yet you could call one sane, and the other crazy, for no greater reason than that one was interviewed before lunch, and the other after.
Such is the foolishness of desiring consistency, that we should seek to avoid identifying the sane as crazy, or the insane as healthy, by establishing clear criteria for determining which is actually which. Certainly your way is better - why bother with diagnosis at all, when one might as well just flip a coin?

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 35 by jar, posted 08-19-2013 7:36 PM jar has replied

Replies to this message:
 Message 37 by jar, posted 08-19-2013 8:02 PM Rahvin has not replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


Message 39 of 77 (704894)
08-19-2013 8:27 PM
Reply to: Message 38 by NoNukes
08-19-2013 8:07 PM


They might well say that. Hank Gathers also claimed to feel better and to play basketball better without his heart medication, but he's dead now because of acting on that feeling. He likely would have felt incomplete being alive without any possibility of becoming an NBA player.
So in this case "harm" meant that it accelerated his own death. Is that how we define "harm?"
If so, does removing a limb hasten death, and thereby cause "harm?" Or is there some other definition you're using?
Conversely, where does quality of life fit into your considerations? For example, when my grandmother was diagnosed with aggressive terminal cancer, she deliberately made decisions that hastened her own death by selecting hospice care rather than continuing treatment. Does this mean that hospice is a form of "harm" and so her decision should be considered indicative of a mental disorder?
If the removal of a limb is considered "harm," how do you consider the quality of life the individual lives? If quality of life could be substantially improved by removing the limb, how does that balance against the "harm" of losing the limb?
Mr Gathers chose to play basketball and, as you say, would have likely felt "incomplete" if he were unable to do so. Which would have been the greater "harm" from his perspective? Is the point of view of anyone else particularly relevant, since each person can make their own decisions for themselves?
In any event, BIID is a real treatable disorder whose symptoms are to want to have a limb removed. Came the same thing be said about people who want sex change operations? If not, then the situations are not the same.
Indeed it can - gender identity dysmorphia is a real treatable disorder whose symptoms are a firm and consistent internal identity as a gender not represented by the patient's physical body, usually coupled with an intense desire to alter the body to bring it into alignment with gender identity. This disorder is treated through the use of hormone therapy in preparation for gender reassignment surgery, which has demonstrated an actual improvement in quality of life for patients who undergo this treatment.
If amputation substantially improves the quality of life of a BIID sufferer, can that not be said to be an effective form of treatment, just as gender reassignment surgery? If not, why not?

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 38 by NoNukes, posted 08-19-2013 8:07 PM NoNukes has replied

Replies to this message:
 Message 40 by NoNukes, posted 08-19-2013 8:46 PM Rahvin has replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


Message 41 of 77 (704897)
08-19-2013 9:07 PM
Reply to: Message 40 by NoNukes
08-19-2013 8:46 PM


That would be an example of harm, and apparently an example which you are willing to accept. But, no, that's not a definition. I could well have used an example of a manic person not taking their medication.
For me personally, I don't have any problem weighing the benefits of what turned out to be a few weeks of college basketball over a human life, and finding the balance favoring life. Neither did Gather's family, which ended up suing LMU.
And yet Mr Gather could have refused to take his medication regardless of what his family or LMU or his doctors or anyone else in the world thought.
The question is not "how would you make this decision." Obviously you and I had different value hierarchies than Mr Gather did; he valued his sport over even his own life.
Relatively sane people make similar decisions all the time - many intelligent people smoke, for example. My uncle made that decision in full awareness of likely outcomes, and now he lies in hospice care with terminal lung cancer, in the final days of his life, about to leave his bipolar wife and autistic son without their primary caregiver...and yet we would not say that his decision to smoke was borne of mental illness.
I would certainly prefer that my uncle had made a different decision, just as Mr Gather's family, I'm sure, wishes desperately that their son had made a different decision.
But the line between disorder and an incredible personal choice (in the literal sense - a choice one cannot understand or comprehend) is not drawn by identifying what we would choose. Down that road lies classifying all minority positions as mental illness.
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?
I'd like to make clear that, despite my vehement replies to jar, my own position is not at all set; I lean in one direction only because I can empathize with a desire not to have my choices regarding my own body made for me by anyone else, even if those choices are harmful (my diet certainly demonstrates that I'm not considerate of "harm" to myself in that respect). I'm tending toward a definition of "harm" as the denial of value fulfillment - values such as body integrity, avoiding pain, retaining property, general health, longevity, and so on - where individuals of similar intelligence may arrive at different value hierarchies than my own and which I may have great difficulty understanding or empathizing with. I'm participating in this discussion in large part as a way to externalize my own thoughts on the matter and expose myself to multiple points of view so that I can determine what my position should actually be.

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 40 by NoNukes, posted 08-19-2013 8:46 PM NoNukes has replied

Replies to this message:
 Message 42 by New Cat's Eye, posted 08-19-2013 10:54 PM Rahvin has not replied
 Message 44 by NoNukes, posted 08-20-2013 5:40 AM Rahvin has replied
 Message 46 by nwr, posted 08-20-2013 9:09 AM Rahvin has not replied

  
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:
 Message 53 by Perdition, posted 08-20-2013 2:21 PM Rahvin has not replied
 Message 55 by NoNukes, posted 08-20-2013 2:40 PM Rahvin has not replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


(1)
Message 61 of 77 (704943)
08-20-2013 6:16 PM
Reply to: Message 56 by jar
08-20-2013 3:09 PM


Re: Harm to others
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.
It takes a cold, cold person to willfully let a human being die because of a missing helmet or seatbelt. Your sense of fairness and justice might make you speak those words on an internet forum, but basic human compassion would sway you in the actual moment, seeing a man immediately after an accident, broken, bleeding, dying in pain when you have the ability to summon help.
Or, at least, I would hope so.
Lots of people say "he got what he deserved" regarding a great many instances of what could be seen as poetic justice, or at the least, nature's punishment of the stupid through the obvious consequences of their ill-advised decisions.
But most people will still feel empathy for an injured person when in their presence, almost regardless of the reason (obvious exceptions are often those injured during the commission of a violent crime).
I don't think I could ever intentionally let a person die because he didn;t wear a helmet or a seatbelt. I might berate him later, I might support charging him more for the care he receives after the fact, but I'd lie about a helmet if necessary to ensure he got to the hospital and received the care in the first place.
Stupidity does not forfeit one's life.

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 56 by jar, posted 08-20-2013 3:09 PM jar has replied

Replies to this message:
 Message 62 by jar, posted 08-20-2013 6:26 PM Rahvin has replied

  
Rahvin
Member
Posts: 4032
Joined: 07-01-2005
Member Rating: 9.2


(1)
Message 63 of 77 (704947)
08-20-2013 6:41 PM
Reply to: Message 62 by jar
08-20-2013 6:26 PM


Re: Harm to others
Again you speak from *********.
Ad hominem. Has it never occurred to you why some words have been censored for you and you alone?
I have been there and done that, seen horrific things.
Your condescension is irrelevant. Your experiences carry no greater weight than those of anyone else. Vague references to "horrific things" does not in any way further this topic. It neither weakens my own argument, nor strengthens your own.
Nor did I say they should not get medical help, only that the public should not have to pay for their *********.
You said:
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.
Given your actual words, perhaps it would have been more effective for you to specify that access to public medical care is not what should be restricted, but rather that the injured party should simply receive the bill.
You might find that you need to make fewer accusations of strawman arguments if you make your arguments more clearly in the first place.

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 62 by jar, posted 08-20-2013 6:26 PM jar has replied

Replies to this message:
 Message 64 by jar, posted 08-20-2013 6:51 PM Rahvin has not replied
 Message 66 by ringo, posted 08-21-2013 1:21 PM Rahvin has not replied

  
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