chapter  44
13 Pages

Body Integrity Identity Disorder (BIID) and the Matter of Ethics

WithNIKKI SULLIVAN

Over the past decade or so there has been increasing interest amongst psychiatrists, psychologists, philosophers, medical ethicists, cultural theorists, neurologists, and others in a range of desires for what we might think of as “non-normative” forms of embodiment, that is, for bodies with less than a “full complement” of limbs, for bodies that are, to varying degrees, paralyzed, deaf, blind, and so on. Such desires are now widely regarded as symptomatic of what psychiatrist Michael Fine calls body integrity identity disorder (BIID), a condition defined primarily by a consistent sense of non-contiguity between body and self. The vast majority of people who identify with the phenomenological sense of bodily being that defines BIID call for access to surgery in order that their desired mode of corporeality be realized, and the dysphoria from which they suffer overcome. Such calls raise a range of questions about the ethics of amputating a healthy limb, injuring a healthy spinal cord, producing deafness, and so on, or, alternately, of refusing to conceive surgery as a viable treatment protocol. This chapter will consider current debates regarding the ethics of “elective amputation”—since this is the procedure which has garnered most interest to date-and at the same time, will attempt to critically interrogate the constitutive effects of the (bio)ethical principles brought to bear on BIID. In other words, rather than simply applying ethical principles to BIID, this chapter strategically deploys the (desire for) “non-normative forms of embodiment” associated with BIID in an attempt to problematize some of the assumptions that underpin what Margrit Shildrick refers to as “conventional bioethics.”