什么是身体完整性认同障碍??

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According to Sophocles,Oedipus the King killed his father and had sex with his mother.直到几年后,然而,that Oedipus found out that he committed patricide and incest—initially not knowing that his father was his father and his mother was his mother.After Oedipus found out what he did,he struck out his own eyes.Oedipus's reason for self-blinding involved guilt and was allegorical: He was initially blind to the atrocious acts that he committed.

The ancient Greeks probably couldn't fathom somebody blinding himself without some tragic reason on the scale of Oedipus's crimes.然而,in modern society,一些人展览”所有权特定身体部位的问题和对残疾的强烈愿望。这些人患有一种称为身体完整性身份障碍的疾病。(比德)and often after years of suffering request to have surgery that results in amputation,失明,deafness or paraplegia.

As you can probably imagine,few surgeons are keen on interfering with organs or limbs without disease.然而,BIID是一个复杂的问题,and some experts advocate for radical surgery as effective treatment.

BIID Examined

在18世纪后期,a French surgeon was forced at gunpoint to amputate a man's 特色在线娱乐城游戏:PT老虎机healthy limb.手术后,the man sent the surgeon payment and a letter of gratitude claiming that the surgery made him feel better.

2000,公众发现一位名叫罗伯特·史密斯的苏格兰外科医生在两名四肢看似正常的病人身上做了截肢手术。When the CEO of Smith's hospital figured out what Smith had done,Smith was forbidden to perform any more amputations.然而,in the wake of these amputations,the debate concerning 特色在线娱乐城游戏:PT老虎机healthy amputation and other seemingly"unnecessary"and debilitating surgery gathered steam.

2015,a 30-year-old woman named宝石树坪claimed that she had her psychologist pour drain cleaner into her eyes so that she could realize her lifelong desire of being失明的.说句公道话,舒平主张的真实性存在争议;nevertheless,关于这种辅助致盲的报道再次强调了BIID。

有BIID的人抱怨感觉”overcomplete"与身体的某一部分疏远,无论是眼睛,limb or so forth.更具体地说,these feelings are lifelong obsessions that result in considerable psychic suffering and trauma.

不清楚是什么导致了BIID。In some people,issues with body identity or ownership can be traced back to definitive pathology such as a brain tumor.然而,在大多数有BIID的人中,the etiology or cause of the disease remains to be elucidated.

研究者谁study BIID已经观察到该病患者的大脑变化。Specifically,顶叶皮质,premotor cortex,脑岛似乎也参与其中。然而,it's unclear whether these brain regions lead to BIID or occur as a consequence of BIID.

Treatment of BIID

如果不清楚BIID的成因,it's difficult to treat the disease.Antidepressants and psychotherapy do little for the disease.Furthermore,像抗精神病药物这样的较重的精神药物还没有在这个病人群体中进行测试。

Interestingly,希望截肢的BIID患者在手术后感觉更好,并报告生活质量改善。值得注意的是,罗伯特·史密斯的两个人,the Scottish surgeon,performed surgery,felt remarkably better after surgery and went on to live happily with prostheses.

许多患有BIID的人都在练习残障人士的生活。这些人被贴上了标签”假装。”By pretending to live with a disability,这些人经历了一些短期的救济,类似于强迫症患者实施强制后的临时救济。

大多数遇到BIID的外科医生对使用根治性手术治疗此病的前景都有一种警觉的反应。These surgeons claim that anybody who wants to amputate a"特色在线娱乐城游戏:PT老虎机“健康”limb has mental illness and limited insight that compromises her ability to give informed consent.

然而,大多数患有BIID的人不是精神病患者,也没有妄想症。此外,一些有BIID经验的人在与BIID一起生活一段时间后产生的抑郁,很可能不是导致这种情况的原因。

在一个papertitled"截肢后的身体完整性身份障碍:同意和自由,"作者艾米·怀特声称,对一个患有BIID的人进行选择性手术切除身体部位的决定并不一定是强迫的,不称职或不称职;因此,经过一个全面的筛选过程,patients with BIID could be candidates for radical surgery.

White also likens BIID togender dysphoriaand radical surgery in those with BIID to sexual reassignment surgery.Specifically,both people with gender dysphoria and BIID feel trapped in a body that is somehow wrong and desire surgery to correct the problem.

相反地,in apapertitled"身体完整性紊乱——健康肢体的截肢是合理的吗?特色在线娱乐城游戏:PT老虎机,"作者Sabina M_ler_假设BIID的根治性手术费用太高,接受治疗的人将无法继续工作,需要终身护理和康复。

M护ller还质疑要求彻底手术的BIID患者是否缺乏对其疾病的了解,并建议采用替代疗法:

BIID可能是一种神经心理障碍,包括对疾病缺乏洞察力和缺乏自主性。不是用不可逆的身体损伤来治疗症状,a causal therapy should be developed in order to integrate the alien limb into the body image.

我们可能还远没有弄清楚如何准确地帮助那些经历过BIID的人。First,research into BIID is low power because very few people have the condition.Much of what we know about BIID is based on anecdotal accounts.Second,BIID可能涉及复杂的神经过程,我们尚未阐明;after all,the brain is ineffably complicated.Third,BIID的根治性手术陷入了伦理考虑的泥潭,进一步模糊了我们对治疗的理解和欣赏。

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文章来源
  • Selected Sources
  • 题为“身体完整性同一性障碍个体肢体拥有的神经基础by MT van Dijk published in PLOS ONE in 2013.
  • Article tilted"身体完整性识别障碍(BIID)-健康肢体的截肢是否合乎道德?特色在线娱乐城游戏:PT老虎机,"由Sabina M_ler出版于美国生物伦理学杂志2009。
  • 题为“Body Integrity Identity Disorder Beyond Amputation: Consent and Liberty"Amy White在HEC论坛in 2014.