The term body integrity identity disorder (BIID) describes the extremely rare phenomenon of persons who desire the amputation of one or more healthy limbs or who desire a paralysis. Some of these persons mutilate themselves; others ask surgeons for an amputation or for the transection of their spinal cord. Psychologists and physicians explain this phenomenon in quite different ways; but a successful psychotherapeutic or pharmaceutical therapy is not known. Lobbies of persons suffering from BIID explain the desire for amputation in (...) analogy to the desire of transsexuals for surgical sex reassignment. Medical ethicists discuss the controversy about elective amputations of healthy limbs: on the one hand the principle of autonomy is used to deduce the right for body modifications; on the other hand the autonomy of BIID patients is doubted. Neurological results suggest that BIID is a brain disorder producing a disruption of the body image, for which parallels for stroke patients are known. If BIID were a neuropsychological disturbance, which includes missing insight into the illness and a specific lack of autonomy, then amputations would be contraindicated and must be evaluated as bodily injuries of mentally disordered patients. Instead of only curing the symptom, a causal therapy should be developed to integrate the alien limb into the body image. (shrink)

As is made plain in the critical apparatus and editorial matter appended to the original German publication of Hussed's Ideas II, I this is a text with a history. It underwent revision after revision, spanning almost 20 years in one of the most fertile periods of the philosopher's life. The book owes its form to the work of many hands, and its unity is one that has been imposed on it. Yet there is nothing here that cannot be traced back (...) to Hussed himself. Indeed, the final" clean copy" for publication, prepared by an assistant, was completely reviewed by the master three times and emended by him in detail on each occasion. Nevertheless, in the end the work was in fact not submitted for publication, and after Hussed's pen last touched the manuscript in 1928 it was set aside until posthumously edited and published by the Hussed-Archives in 1952. The story of the composition of Ideas II begins with the "pencil manuscript" of 1912. This is the ultimate textual source for both Ideas II and Ideas III. 2 It has been preserved as a folio of 84 sheets in very dense shorthand of the Gabelsberger system, written mostly with a pencil. It was composed by Hussed "in one stroke" immediately after the completion of I Edmund Husser!: Ideen zu einer reinen Phiinomenologie und phiinomenologischen Philosophie. Zweites Buch: Phiinomenologische Untersuchungen zur Konstitution. Edited by Marly Biemel. The Hague: Martinus NijhofT, 1952 (Husserliana IV). (shrink)

This essay argues that Merleau-Ponty’s phenomenology of embodiment can be an extremely helpful ally for contemporary feminist theorists, critical race theorists, and disability studies scholars because his work suggests that the gender, race, and ability of bodies are not innate or fixed features of those bodies, much less corporeal indicators of physical, social, psychic, and even moral inferiority, but are themselves dynamic phenomena that have the potential to overturn accepted notions of normalcy, naturalness, and normativity. Taking seriously Merleau-Ponty’s insistence that (...) our bodies are the means by which we directly engage with the world, I suggest, encourages us to be attentive to how an individual’s or group’s gender, race, and bodily abilities differentially affect how their bodies are responded to by other bodies. The responses of others, in turn, directly influences the significance of an individual’s actions within that situation. This essay provides a critical examination of specific feminist philosophers, critical race scholars, and disability theorists who creatively utilize Merleau-Pontian insights to illustrate, and ultimately combat, the insidious ways in which sexism, racism, and “compulsory able-bodiedness”, impoverish the lived experience of both oppressors and the oppressed, largely by predetermining the meaning of their bodily interactions in accordance with institutionalized cultural expectations and norms. (shrink)

This article discusses the acquisition of a physical impairment/disability through voluntary body modification, or transability. From the perspectives of critical genealogy and feminist intersectional analysis, the article considers the ability and cis*/trans* axes in order to question the boundaries between trans and transabled experience and examines two assumptions impeding the conceptualization of their placement on the same continuum: 1) trans studies assumes an able-bodied trans identity and able-bodied trans subject of analysis; and 2) disability studies assumes a cis* disabled identity. (...) The perception of transsexuality and transability as mutually exclusive phenomena results from a nonintersectional analysis of transsexuality as an issue of sex/gender, but not of ability, and of transability as an issue of ability, but not of sex/gender. Difficulty recognizing continuities between these phenomena thus stems from an ableist interpretation of sex/gender and a cisnormative* interpretation of ability. This article aims to: 1) enrich intersectional analysis in trans and disability studies and transability scholarship; 2) complicate disability studies, in which disabilities are often presumed to be “involuntary,” and encourage the decentering of a cis* subject; 3) encourage trans studies to decenter an able-bodied subject; and 4) advocate for increased dialogue and the creation of alliances between trans and disability studies and movements. (shrink)

Body integrity identity disorder (BIID), formerly also known as apotemnophilia, is characterized by a desire for amputation of a healthy limb and is claimed to straddle or to even blur the boundary between psychiatry and neurology. The neurological line of approach, however, is a recent one, and is accompanied or preceded by psychodynamical, behavioural, philosophical, and psychiatric approaches and hypotheses. Next to its confusing history in which the disorder itself has no fixed identity and could not be classified under a (...) specific discipline, its sexual component has been an issue of unclarity and controversy, and its assessment a criterion for distinguishing BIID from apotemnophilia, a paraphilia. Scholars referring to the lived body—a phenomenon primarily discussed in the phenomenological tradition in philosophy—seem willing to exclude the sexual component as inessential, whereas other authors notice important similarities with gender identity disorder or transsexualism, and thus precisely focus attention on the sexual component. This contribution outlines the history of BIID highlighting the vicissitudes of its sexual component, and questions the justification for distinguishing BIID from apotemnophilia and thus for omitting the sexual component as essential. Second, we explain a hardly discussed concept from Maurice Merleau-Ponty’s Phenomenology of Perception (1945a), the sexual schema, and investigate how the sexual schema could function in interaction with the body image in an interpretation of BIID which starts from the lived body while giving the sexual component its due. (shrink)

While disability has emerged as a major theme in academic and political discourses, a perusal of many bioethics textbooks reveals that most editors and philosophers still do not consider disability to be central to developing either critical perspective or social conscience in addressing the core questions in bioethics. This essay explores how disability issues are typically portrayed in bioethics textbooks by looking at the examples of genetic testing and medically assisted death. It explains how incorporation of disability perspectives helps to (...) provide students with opportunities for a fuller understanding of many concepts that are central to moral and political philosophy, such as equality, justice, the good life, moral agency, and autonomy. (shrink)

In 1997, a Scottish surgeon by the name of Robert Smith was approached by a man with an unusual request: he wanted his apparently healthy lower left leg amputated. Although details about the case are sketchy, the would-be amputee appears to have desired the amputation on the grounds that his left foot wasn’t part of him – it felt alien. After consultation with psychiatrists, Smith performed the amputation. Two and a half years later, the patient reported that his life had (...) been transformed for the better by the operation [1]. A second patient was also reported as having been satisfied with his amputation [2]. (shrink)

This article is a phenomenological exploration and description of certain selected aspects of living the specificities and conundrums posed by what is usually, if problematically, called a ‘phantom limb’. Using my own body as an ‘intimate laboratory’, I attend to the dynamics and mutability of the supposed ‘phantom’, both during the post-operative period of the above-the-knee amputation of my left leg as well as after I began to use and incorporate my prosthetic leg. Throughout, I explore the reversible aspects of (...) my two legs as ‘phantom’ and ‘real’, present and absent, and visible and invisible — paying attention, as well, to the lived and linguistic sense we make of our bodies in ‘parts’ and our bodies as ‘whole’. (shrink)

This paper focuses on epistemic practices within biomedical ethics that are related to disability. These practices are one of the reasons that there is tension between biomedical ethicists and disability advocates. I argue that appeals to conceptual neutrality regarding disability, which Anita Silvers recommends, are counterproductive. Objectivity as neutrality serves to obscure the social values and interests that inform epistemic practices. Drawing on feminist standpoint theory and epistemologies of ignorance, I examine ways that appeals to objectivity as neutrality serve to (...) maintain the status quo and ignorance regarding disability. I adapt Charles Mills’s notion of “white ignorance” in order to consider the systematic social ignorance regarding disability that is treated as knowledge. Bioethicists commonly dismiss the reports of disabled people regarding their quality of life as biased, while claiming that their own judgments are objective. Sandra Harding’s notion of strong objectivity is useful for thinking about ways that examination of values and interests informing epistemic practices related to disability in biomedical ethics could create better knowledge practices by taking the standpoint of disabled people seriously. (shrink)

This dissertation contributes to the development of philosophy of disability by drawing on disability studies, feminist philosophy, phenomenology, and philosophy of biology in order to contest epistemic and ontological assumptions about disability within biomedical ethics as well as within philosophical work on the body, demonstrating how philosophical inquiry is radically transformed when experiences of disability are taken seriously. In the first two chapters, I focus on epistemological and ontological concerns surrounding disability within biomedical ethics. Although disabled people and their advocates (...) have been quite vocal regarding their views on disability and in critiquing bioethicists’ approaches to issues that affect them, the interests, knowledge, and experiences of disabled people have had minimal impact on discussions within biomedical ethics textbooks. The risks of making problematic assumptions about disability are high within this subfield insofar as bioethicists impact practices within medical facilities, public policy, and, through student engagement with their texts in biomedical ethics courses, the views of potential health care professionals. All of these, in turn, affect the care provided to disabled people and potential/actual parents of disabled children. Chapter three raises ontological issues related to disability theory, examining the role of the impairment/disability distinction in framing discussions of the body as well as the status of experience. I discuss two approaches to incorporating subjective experiences of the body in disability, arguing that neither is sufficient. I examine debates within feminist theory on questions related to experience. I argue that a feminist phenomenological approach that builds on Merleau-Ponty’s work offers the best way to address bodily experiences in disability theory. The assumptions that disability theorists and Merleau-Ponty make about disability are often at odds. Chapter four points out the ableism in Merleau-Ponty’s use of a case study and considers some of the oversights within Phenomenology of Perception. In spite of my critique, I argue that his approach to phenomenology—with appropriate modifications—is useful not only for theorizing the experiences of disabled people but also for addressing other types of marginalized embodiment. Chapter five applies this method to body integrity identity disorder (BIID), arguing that combining Merleau-Ponty’s insights with those of disability theory allows us to address lived experiences of BIID and to identify assumptions about disability within research on this condition. (shrink)

Disabled women's issues, experiences, and embodiments have been misunderstood, if not largely ignored, by feminist as well as mainstream disability theorists. The reason for this, I argue, is embedded in the use of materialist and constructivist approaches to bodies that do not recognize the interaction between “sex” and “gender” and “impairment” and “disability” as material-semiotic. Until an interactionist paradigm is taken up, we will not be able to uncover fully the intersection between sexist and ableist biases that form disabled women's (...) oppressions. Relying on the understanding that sexuality is one such material-semiotic phenomenon, I examine the operation of interwoven biases in two disabled women's narratives. (shrink)

Controversy swept the U.K. in January of 2000 over public disclosure of the fact that a Scottish surgeon named Robert Smith had amputated the limbs of two able-bodied individuals who reportedly suffered from a condition known as apotemnophilia. The patients, both of whom had sought and consented to the surgery, claimed they had desperately desired for years to live as amputees and had been unable, despite considerable efforts, to reconcile themselves psychologically to living with the bodies with which they were (...) born. Both surgeries were successful, and both patients, who had undergone psychiatric evaluation prior to the amputations, subsequently reported having no regrets. In the wake of a wave of sensationalistic stories in the media, the hospital at which the surgeries had been performed, the Falkirk and District Royal Infirmary, banned any future surgeries of the kind. Outraged local politicians promptly announced their intention to pass laws banning the procedure outright. One member of Scottish Parliament declared the surgery obscene and asserted that the whole thing is repugnant and legislation needs to be brought in now to outlaw this. (shrink)

Patient support tools have drawn on a variety of disciplines, including psychotherapy, social psychology, and social care. One discipline that has not so far been used to support patients is philosophy. This paper proposes that a particular philosophical approach, phenomenology, could prove useful for patients, giving them tools to reflect on and expand their understanding of their illness. I present a framework for a resource that could help patients to philosophically examine their illness, its impact on their life, and its (...) meaning. I explain the need for such a resource, provide philosophical grounding for it, and outline the epistemic and existential gains philosophy offers. Illness often begins as an intrusion on one’s life but with time becomes a way of being. I argue that this transition impacts on core human features such as the experience of space and time, human abilities, and adaptability. It therefore requires philosophical analysis and response. The paper uses ideas from Husserl and Merleau-Ponty to present such a response in the form of a phenomenological toolkit for patients. The toolkit includes viewing illness as a form of phenomenological reduction, thematizing illness, and examining illness as altering the ill person’s being in the world. I suggest that this toolkit could be offered to patients as a workshop, using phenomenological concepts, texts, and film clips to reflect on illness. I conclude by arguing that examining illness as a limit case of embodied existence deepens our understanding of phenomenology. (shrink)

Controversy swept the U.K. in January of 2000 over public disclosure of the fact that a Scottish surgeon named Robert Smith had amputated the limbs of two able-bodied individuals who reportedly suffered from a condition known as apotemnophilia. The patients, both of whom had sought and consented to the surgery, claimed they had desperately desired for years to live as amputees and had been unable, despite considerable efforts, to reconcile themselves psychologically to living with the bodies with which they were (...) born. Both surgeries were successful, and both patients, who had undergone psychiatric evaluation prior to the amputations, subsequently reported having no regrets. In the wake of a wave of sensationalistic stories in the media, the hospital at which the surgeries had been performed, the Falkirk and District Royal Infirmary, banned any future surgeries of the kind. Outraged local politicians promptly announced their intention to pass laws banning the procedure outright. One member of Scottish Parliament declared the surgery obscene and asserted that the whole thing is repugnant and legislation needs to be brought in now to outlaw this. (shrink)