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Id. The politician in question, Dennis Canavan, represents Falkirk, the region in which the hospital that allowed the amputations is located.Google Scholar

The paradoxical logic of apotemnophilia is exemplified in the incongruous statements that apotemnophiles make to describe their unwanted limbs. See, e.g., Dotinga, supra note 5 (quoting one man as saying, “It’s about becoming whole, not becoming disabled.”);Elliott, C., “A New Way to Be Mad,” The Atlantic Monthly 286, no. 6 (2000): 76 (quoting a woman as saying that she “will never feel truly whole with legs” and an amputee as saying that “[his] left foot was not part of [him]”);Complete Obsession (BBC documentary, Feb. 17, 2000) (interviewing the same woman quoted above, who says that “at best [her] legs seem extraneous … as if they’re not a part of [her]”).Google Scholar

See People v. Brown, 91 Cal. App. 4th 256 (2001) (upholding unlicensed surgeon’s conviction on counts of second degree murder and unlawful practice of medicine).Google Scholar

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Id. at 372. Koch quotes one commentator who asserts that because disability is “inherently harmful,” the disabled individual “has a strong rational preference not to be in such a condition.” Id.Google Scholar

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See generally Teff, H., Reasonable Care: Legal Perspectives on the Doctor-Patient Relationship (Oxford: Clarendon Press, 1994). Exploring the evolution of patients’ rights doctrine in common-law legal systems, Teff cites Justice Cardozo’s formulation in Schloendorff v. Society of New York Hospital, 211 N.Y. 125, 128 (1914);that “every human being of adult years and sound mind has a right to determine what shall be done with his own body.” Teff, at 131. Teff points out that Cardozo’s formulation had been anticipated in earlier decisions containing strong dicta about the individual’s right to bodily integrity. Among these cases is Pratt v. Davis, 118 Ill. App. 161, 166 (1905), which declared that “the free citizen’s first and greatest right, which underlies all the others — the right to the inviolability of his person, in other words, his right to himself.” Teff, at 132.Google Scholar

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Caplan questions the competence of apotemnophiles, whom he characterizes as “running around saying ‘Chop my leg off.” Dotinga, , supra note 5. The issue of competence to consent is a crucial one, given the importance of informed consent to both the practice of medicine and the law of medical malpractice. It is with respect to this issue that Smith and Furth’s campaign to have apotemnophilia formally recognized as a psychiatric disorder could actually present an obstacle to elective amputation. The argument that apotemnophiles suffer from a debilitating mental disorder is difficult to square with Smith’s contention that apotemnophiles are fully mentally competent to consent to the amputations they seek. It is a well-settled rule, however, that the law regards patients as presumptively sane and competent to consent.Lockwood, R. H., Annotation, Mental Competency of Patient to Consent to Surgical Operation or Medial Treatment, 25 A.L.R. 3d 1439 (2001). This presumption has been held to be unaffected by the sole fact that the patient is being treated for a mental condition. Id. Even patients whose mental illness is sufficiently severe to justify involuntary commitment are presumed competent to elect or to decline treatment unless there has been a judicial determination of incompetency.Mills v. Rogers, 57 U.S. 291 (1982);Rivers v. Katz, 495 N.E.2d 337 (N.Y. 1986) (upholding the right of institutionalized mentally ill patients to refuse forced treatment with antipsychotic drugs).Google Scholar

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