Body Integrity Identity Disorder (BIID) is a very rare condition describing those with an intense desire or need to move from a state of ability to relative impairment, typically through the amputation of one or more limbs. In this paper, I draw upon research in critical disability studies and philosophy of disability to critique arguments based upon the principle of nonmaleficence against such surgery. I demonstrate how the action-relative concept of harm in such arguments relies upon suspect notions of biological (...) and statistical normality, and I contend that each fail to provide normative guidance. I then propose a critical theory of harm, one marked by substantive engagement with both empirical and reflective inquiry across the sciences, social sciences, and humanities. I conclude by discussing the implications of this theory and how it might enrich ongoing debates in bioethics, philosophy of disability, and the health humanities. (shrink)

The Asymmetry in procreative ethics consists of two claims. The first is that it is morally wrong to bring into existence a child who will have an abjectly miserable life; the second is that it is permissible not to bring into existence a child who will enjoy a very happy life. In this paper, I distinguish between two variations of the Asymmetry. The first is the Abstract Asymmetry, the idealized variation of the Asymmetry that many philosophers have been trying to (...) solve. The second is the Real-World Asymmetry, a non-idealized variation that applies explicitly to cases of ordinary human reproduction. I argue that the Real-World Asymmetry can be defended by properly acknowledging the general wrongness of causing someone else to suffer, the limits of what morality can reasonably demand of us, and the significance of respecting women’s autonomy. I then argue that the Abstract Asymmetry is indefensible. (shrink)