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Giving a leg up part 2: the ethical challenges of Body Integrity Dysphoria

Published online by Cambridge University Press:  01 September 2022

G. Dumais-Lévesque*
Affiliation:
Université Laval, Département De Psychiatrie Et Neurosciences, Québec, Canada
S. Pham Thi-Desmarteau
Affiliation:
Université Laval, Département De Psychiatrie Et Neurosciences, Québec, Canada Hôpital de l’Enfant-Jésus, Consultation-liaison Psychiatry, Quebec, Canada
*
*Corresponding author.

Abstract

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Introduction

Body Integrity Dysphoria (BID) is a diagnosis, newly described in ICD-11, “characterised by an intense and persistent desire to become physically disabled in a significant way… accompanied by persistent discomfort, or intense feelings of inappropriateness concerning current non-disabled body configuration”. Patients with BID may request the amputation of healthy limbs but this raises multiple ethical challenges.

Objectives

By the end of the presentation, participants 1) will better understand the new diagnosis of Body Integrity Dysphoria; 2) will be able to have some landmarks to evaluate and manage this rare condition 3) will discern the ethical challenges raised by an elective or emergent amputation request.

Methods

We present a complex case we faced in Quebec City, Canada. A young adult admitted to the intensive care and burn unit was referred to our Consultation Liaison (CL) team. For the second time in a year, the individual deliberately burned his leg, with the intention of having an amputation. Based on the available literature and our experience, we explore the ethical aspects of this case.

Results

For this situation, the multidisciplinary team faced uncertainty and ambivalence toward the best treatment options. Deontological concerns and ethical issues emerged from the patient’s request for amputation.

Conclusions

We outline how ethical concepts helped us to gain a shared comprehension of the patient’s extraordinary request, both during treatment and afterwards.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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