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Home / Thoughts / BIID ethics, schmetics

BIID ethics, schmetics

Written by Sean on Thursday, April 10, 2008

There’s been discussions about ethics surrounding BIID. One of the discussions was about a "code of ethics" for medical professionals treating transabled individuals presenting to the Emergency Department with self-inflicted injuries. Other discussions focus on whether or not it would be ethical to provide surgery as an accepted treatment option for people who have Body Integrity Identity Disorder (BIID). I won’t cover the first one, as that could use an entire post or three on its own, and in fact, I shan’t build an argument about the ethics of a surgical solution, but it is important to consider the background of the people having these discussions.

Most of that discourse is happening in academic journals. There are a few academics who have published on the topic. Bayne & Levy wrote something in 2005. Caplan is quoted in a popular psychology magasine. Elliott has written several articles, a couple of which have also been published in books. Singer hasn’t written on the topic that I know of, but he was an editor on one of Elliott’s book. There may be other well known bio-ethicists that have spoken about BIID and surgery as a solution to BIID, but I have not seen them (please feel free to let me know if you find anything else!).

In theory, we should judge someone’s argument merely on the strength of the argument presented. If the argument makes sense, we take it on board. If it doesn’t, we discard it. But life isn’t that simple, is it? In practice, we really ought to consider the author’s stance on "disability" as well. Why? Because if someone is "anti-disability", they are unlikely to be objective on the topic. The ideal would be someone neutral (or appearing to be so). I’ll readily admit that one should question an ethical argument coming from someone "pro-disability" as well as those who are against. So, let’s look at the authors I listed previously:

Tim Bayne & Neil Levy

They don’t have a record of being particularly against disability, nor particularly in supportive. Either way, I think they could be considered "neutral".

They seem to support surgery for BIID.

Arthur Caplan

He is generally regarded by the disability community as being “anti-disability”. If that statement appears too strong, then, let’s say that he tends to support euthanasia/physician assisted suicide, and peole with disabilities are often a victim-group (and no, I won’t go into a debate on physician assisted suicide in this post!)

Caplan is against surgery, and quite vehemently at that.

Carl Elliott

Elliott doesn’t have a track record in favour or against people with disabilities, although one might consider him “tainted by association” with Singer.

Elliott is opposed to surgery

Peter Singer

Singer is probably one of the most reviled figures of bio-ethics by the disability community. While he was a champion of animal rights and suggested the concept of “person” where pets might be persons, he has used that same concept to state that people with disabilities are unable to appreciate life and as such might not be persons (grossly simplified, you have to read his books). He further advocates that as disabled infants are “non-persons”, we should be able to kill them up to 28 days old!!!

Singer has not published a position on BIID nor surgery for BIID

Could we really consider anything Singer wrote about BIID without at least acknolwedging his stance on disability? If someone is known to think disability is a faith worse than death, can we be trully surprised if they say that the acquisition of an impairment as a solution to BIID is bad?

I don’t suggest that their arguments should be discarded, otherwise we should discard all my arguments in favour of surgery for BIID. I am after all biased in favour of surgery. But consider the messenger when hearing the message. And yes, that goes for me as well - I have no fear that my position is solid.

Tags: BIID, Ethics, Bio-ethicist, Bayne, Levy, Singer, Caplan, Elliott, Surgery

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