Question

Bodily Identity Integrity Disorder. Since she was a young child, Jewel Shuping dreamed of being blind. "When I was young my mother would find me walking in the halls at night, when I was three or four years old," she says. "By the time I was six I remember that thinking about being blind made me feel comfortable." She would stare at the sun for hours, hoping that it would damage her eyes. As a teenager, she began wearing thick black glasses and carrying a white cane. By the time she was 20 years old, she was fluent in braille, Shuping describes her desire to be blind as a "non-stop alarm that was going off" in her head. Finally, at nearly 30, she found a psychologist willing to help blind her by putting a couple of drops of drain cleaner in each eye. Though the process was painful, she remained hopeful: "all I could think was 'I am going blind, it is going to be okay."' The drain cleaner severely damaged her eyes but did not render her completely blind, so she is not satisfied with the result. Nevertheless, she has said she is happy to be "much further along her path to blindness."3 She explains: "I really feel this is the way I was supposed to be born, that I should have been blind from birth. When there is nobody around you who feels the same way, you start to think that you're crazy. But I don't think I'm crazy, I just have a disorder."

Bodily Integrity Identity Disorder (BIID) is a rare condition where there is a conflict between a person's actual, physical body and their idea of how their body should be. It usually involves an able-bodied person who believes that they should be disabled in some way.4 The most common manifestation of the disorder is a desire to have a specific body part amputated.

Getting such procedures done does not cure BIID. However, for many who have BIID, the desire to make their bodies match how they feel they are meant to be is so strong that they are willing to take desperate measures to make it happen. Such measures might include putting drain cleaner in their eyes like Jewel Shuping, cutting off their own limbs, or jumping off cliffs in order t,o paralyze themselves.

A doctor cannot amputate a healthy limb without risking his or her license. A Scottish surgeon who performed two such surgeries in the late nineties was banned from performing any more. He had given the issue considerable thought, consulted his professional organization, and received written permission from his hospital's chief executive. His patients were convinced that surgery was the only relief for their condition and were completely happy with the results of the procedures. One such patient says he finally feels like a complete person now that he is an amputee.

1. In the absence of a more effective way of managing BIID, is it in the interests of BIID patients to give them body modifications they want?
2. If BIID patients are likely to resort to dangerous measures to modify their bodies, is this a good enough reason to allow doctors to perform these modifications?
3. Do BIID patients harm themselves when they modify their bodies to give themselves disabilities?

Answer 1

In the absence of a more effective way of managing BIID, is it in the interests of BIID patients to give them body modifications they want?

The Bodily Integrity Identity Disorder (BIID) is essentially a psychological disorder where the insight of one's own body is altered by the amputation or self harm psychology in order to feel complete and good about themselves. Tt is also a neurological conditions where where the individual's body projection in the form of disability and present healthy body is not in alignment. For an individual who has this serious neuropsychological condition his/ her ability or interest of body modifications is not a correct choice as their ability to make sound and well though decisions is neuropsychologically affected as they lack insight and autonomy. This lack of insight and autonomy for body mortification should be contraindicated and it is not in the interests of BIID patients to give them body modifications they want.

If BIID patients are likely to resort to dangerous measures to modify their bodies, is this a good enough reason to allow doctors to perform these modifications?

For doctors this is a question of human and medical ethics as the role of a doctor by education and as a human is to provide the best possible medical treatment and sound medical advise in order to care the patient and ensure safety at the same time. On on hand the dilemma is that the individuals with BIID should have the autonomy over their bodies and on the other hand the concept of autonomy on BIID individuals is altered and their ability or need to self harm s not in their health or safety interests. So if the BIID patients are likely to resort to dangerous measures to modify their bodies, the doctor can treat the patient with counseling and related symptoms but under no conditions the doctor can support or even carry out any modification procedures

Do BIID patients harm themselves when they modify their bodies to give themselves disabilities?

Yes, the BIID patient do indeed harm themselves physically when they give themselves disabilities just like any normal human beings. The only difference is the altered perception of people with BIID that they shall in future after body modification will feel better. But feeling better can no way justify the serious amputations of body modification and can affect the health and safety of the person. Also, it is a neropsychologocal disorder and body modification can seriously alter their condition even further as there is no guarantee or medical cure that after any body modification these individuals shall feel good or be able to lead the life with disability. Therefore it is incorrect and fundamentally wrong to harm or modify body and BIID patients certainly harm themselves when they modify their bodies to give themselves disabilities