ABSTRACT
This chapter argues that if patients are experiencing significant distress as a consequence of the rare psychological disorder named Body Integrity Identity Disorder (BHD), such operations might be permissible. It discusses two basic questions. First, what would motivate someone to have an apparently healthy limb amputated? Second, under what conditions is it reasonable for doctors to accede to such requests? The chapter explores three arguments for allowing self-demand amputation of healthy limbs: the argument from harm minimization, the autonomy argument and the therapeutic argument. The BHD account can be developed in different ways depending on the type of bodily representation that is thought to be involved. A more plausible possibility is that BHD involves a mismatch between the wannabe’s body and their body image. Most wannabes appear to have some form of BHD: they appear to be motivated to achieve a fit between their body and their body image.
