# Is it common practice to offer amputation to patients recently suffering from a spinal cord injury? **URL:** \ **Category:** Factual Questions\ **Created:** [November 21, 2011, 7:53pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676 "2011-11-21T19:53:21Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Boyo\_Jim](https://avatars.discourse-cdn.com/v4/letter/b/87869e/32.png) [@Boyo\_Jim](https://boards.straightdope.com/u/Boyo_Jim)\ **Post date:** [November 22, 2011, 9:07am UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/21 "2011-11-22T09:07:31Z")
Doctors are not obliged to perform any particular medical procedures, even relatively minor and low risk ones. In my early 20s I tried to get a vasectomy, and was refused by half a dozen doctors. They all thought I was too young to make a decision with such long term consequences, particularly since I was unmarried and had no children. Who knows what little morality plays were running through their heads. But they apparently couldn’t rap their heads around the idea of someone my age knowing I didn’t want children. Anyway, I gave up for a long time and finally had one in my mid 30s, still unmarried and childless. And now I’m in my mud 50s and still unmarried and childless. ::Maxwell Smart:: “And loving it.” ---
**Author:** ![Vicullum](https://avatars.discourse-cdn.com/v4/letter/v/6de8d8/32.png) [@Vicullum](https://boards.straightdope.com/u/Vicullum)\ **Post date:** [November 22, 2011, 11:16am UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/22 "2011-11-22T11:16:15Z")
> [@Boyo\_Jim](#): > > Doctors are not obliged to perform any particular medical procedures, even relatively minor and low risk ones. In my early 20s I tried to get a vasectomy, and was refused by half a dozen doctors. They all thought I was too young to make a decision with such long term consequences, particularly since I was unmarried and had no children. Interesting…I thought vasectomies are reversible though, no? ---
**Author:** ![Lucretia](https://avatars.discourse-cdn.com/v4/letter/l/13edae/32.png) [@Lucretia](https://boards.straightdope.com/u/Lucretia)\ **Post date:** [November 22, 2011, 12:37pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/23 "2011-11-22T12:37:49Z")
You see ‘elective’ amputations a fair amount with combat injuries. Often, it’s not clear cut as to which would be more useful, the fixed-as-best-as-we-can natural limb, or a prosthesis. There’s a fair amount of people who, after attempting rehab with the natural limb, elect an amputation and prosthetic(s). Many times they end up with much better function, and much less pain. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [November 22, 2011, 1:19pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/24 "2011-11-22T13:19:01Z")
> [@Vicullum](#): > > Interesting…I thought vasectomies are reversible though, no? It involves microsurgery, it’s far more expensive than a vasectomy, it is not always successful, and the more time has passed since the initial vasectomy the less likely a reversal is to be successful. Even when the plumbing is re-connected fertility is not always restored. Saying vasectomies are reversible is like saying tattoos are removable - yeah, sort of. One should consider any vasectomy to be permanent. ---
**Author:** ![smiling\_bandit](https://avatars.discourse-cdn.com/v4/letter/s/e9a140/32.png) [@smiling\_bandit](https://boards.straightdope.com/u/smiling_bandit)\ **Post date:** [November 22, 2011, 1:37pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/25 "2011-11-22T13:37:22Z")
> [@Bear\_Nenno](#): > > I bet that by the time we have the technology to fix a severed spinal cord, reattaching and/or regrowing new legs would be trivial. OK, Bear\_nenno, I don’t want to dumop on you but this is flat nonsense. Work is already being done on repairing nerves, including the spine. Regrowing limbs is something we can barely conceive of, and then only in complete fiction. ---
**Author:** ![Skammer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/skammer/32/143_2.png) [@Skammer](https://boards.straightdope.com/u/Skammer)\ **Post date:** [November 22, 2011, 2:53pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/26 "2011-11-22T14:53:18Z")
> [@Skammer](#): > > My sister-in-law is quadrapelegic and we’ve teased her about getting her limbs amputated (as we all get older, it gets harder and harder to transfer her in and out of bed/her chair/the car). I can’t imagine ever actually doing it, though. They don’t work but they’re still part of her. > [@ZenBeam](#): > > :dubious: I don’t know you or your sister-in-law, or any quadrapelegics, but joking about that seems very wrong to me. > [@obbn](#): > > I don’t know. Humor is what keeps us all sane, esp. when something awful happens. Through my divorce and my injury (broken back) I and my friends upon my starting it made fun of my situation. Without the humor I don’t think I could have gotten through it. My SIL is 45 now, and has been in a wheelchair since she was 30 due to chronic progressive MS. When I met her 12 years ago she had use of her upper body, except for her fingers; today she has no mobility at all and struggles to keep her head upright and swallow her food without choking. She’ll never marry or have children of her own. She has to to be fed, dressed, showered, and have her butt wiped by her sisters or a home aide. She rarely leaves the house because being transferred from her wheelchair to a car seat and back again is painful, and difficult. Before her illness she was an artist and an avid reader; now she cannot pick up a paintbrush or turn the page of a book. She tires easily and speaks very softly, and strangers routinely ignore her, assuming she can’t talk. She’ll never be able to go to the family cabin again where she spent every summer growing up. She wants to be treated normal. In my sister’s family, they tease each other. It’s how they show their love. It’s not something we’re going to take away from her, like it’s one more thing she can’t be a part of. If they all can’t deal with her disability with laughter that only leaves the tears. ---
**Author:** ![OpalCat](https://avatars.discourse-cdn.com/v4/letter/o/8edcca/32.png) [@OpalCat](https://boards.straightdope.com/u/OpalCat)\ **Post date:** [November 22, 2011, 5:55pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/27 "2011-11-22T17:55:09Z")
> [@phouka](#): > > I have no idea if a person were both paraplegic and morbidly obese if amputating the legs might lower the demand on their cardiovascular system or what. I think I remember my husband explaining to me that after a below-the-knee amputation (the only kind he can do, as a podiatrist) there is actually _greater_ strain on the cardiovascular system, but I can’t remember the explanation, and I may be misremembering entirely. I will ask him today/tonight if I remember and report back. I would assume that if it’s true for a BTK amputation, it would be the same for a both-the-legs amputation. ---
**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\ **Post date:** [November 22, 2011, 6:23pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/28 "2011-11-22T18:23:21Z")
> [@OpalCat](#): > > I think I remember my husband explaining to me that after a below-the-knee amputation (the only kind he can do, as a podiatrist) there is actually _greater_ strain on the cardiovascular system, but I can’t remember the explanation, and I may be misremembering entirely. I will ask him today/tonight if I remember and report back. I would assume that if it’s true for a BTK amputation, it would be the same for a both-the-legs amputation. I seem to remember reading something about that a number of years ago in some articles about diabetics - I believe it has something to do with the movement of blood back to the heart and movement of the lower leg. I wish I still had access to the library - I am up in Rochester visiting my Mom and about 400 miles away from Yale… ---
**Author:** ![OpalCat](https://avatars.discourse-cdn.com/v4/letter/o/8edcca/32.png) [@OpalCat](https://boards.straightdope.com/u/OpalCat)\ **Post date:** [November 22, 2011, 6:34pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/29 "2011-11-22T18:34:28Z")
I just texted my husband and he verified that yes, it increases the stress. I’ll ask him about the why later tonight and post what he says. ---
**Author:** ![psychobunny](https://avatars.discourse-cdn.com/v4/letter/p/54ee81/32.png) [@psychobunny](https://boards.straightdope.com/u/psychobunny)\ **Post date:** [November 23, 2011, 7:43pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/30 "2011-11-23T19:43:15Z")
Just an FYI-a limb amputation is a fairly simple straightforward procedure nowhere near as complicated or risky as gastric bypass or sex reassignment. They have been done successfully since the civil war days. [This site](http://www.huntermcguire.goellnitz.org/amputation.html) gives a primary 28% mortality rate for civil war amputations which given the lack of aseptic technique or antibiotics and battlefield conditions is pretty incredible. Incidentally, it also describes the procedure which is pretty much the same as it is done today. Amputation is considered an easy default-much less traumatizing, for example, than skin grafts to cure wounds. Just wanted to fight ignorance. Please resume your prior discussion. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [November 24, 2011, 3:47am UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/31 "2011-11-24T03:47:33Z")
> [@Ambivalid](#): > > But doesn’t amputation, in and of itself, carry some fairly significant medical risks? I would think such a procedure would (and I thought _is_) be reserved for only medically necessary cases. Concur. It is surely against the Hippocratic oath for doctors to willy-nilly accede to such requests (didn’t the Joker go to Mexico?). If your right hand causes you to sin, cut it off and throw it away! It is better to lose one of your members than to have your whole body go into hell (Matthew 5:27-30) is a metaphor, thankfully. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [November 24, 2011, 9:26pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/32 "2011-11-24T21:26:55Z")
> [@psychobunny](#): > > Just an FYI-a limb amputation is a fairly simple straightforward procedure nowhere near as complicated or risky as gastric bypass or sex reassignment. They have been done successfully since the civil war days. [This site](http://www.huntermcguire.goellnitz.org/amputation.html) gives a primary 28% mortality rate for civil war amputations which given the lack of aseptic technique or antibiotics and battlefield conditions is pretty incredible. Incidentally, it also describes the procedure which is pretty much the same as it is done today. Amputation is considered an easy default-much less traumatizing, for example, than skin grafts to cure wounds. Just wanted to fight ignorance. Please resume your prior discussion. [http://www.nhs.uk/Conditions/Amputation/Pages/Risks.aspx](http://www.nhs.uk/Conditions/Amputation/Pages/Risks.aspx) I’m not sure where you are getting your info, but these statistics seem to paint a different picture. ---
**Author:** ![elbows](https://avatars.discourse-cdn.com/v4/letter/e/b3f665/32.png) [@elbows](https://boards.straightdope.com/u/elbows)\ **Post date:** [November 24, 2011, 9:44pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/33 "2011-11-24T21:44:03Z")
Anyone else surprised a podiatrist can do an amputation? Learn something new everyday! ---
**Author:** ![Lasciel](https://avatars.discourse-cdn.com/v4/letter/l/e79b87/32.png) [@Lasciel](https://boards.straightdope.com/u/Lasciel)\ **Post date:** [November 24, 2011, 10:25pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/34 "2011-11-24T22:25:05Z")
> [@Ambivalid](#): > > So what you are saying is a doctor is obliged to perform a procedure if it’s something that the person wanting it is willing to do on their own? So if a person comes to a doctor and says “Doc, I’m so depressed I can’t take it anymore. If you don’t chop off both my feet and both my hands, I’m gonna do it myself in a meat grinder”, that doctor would be obliged to amputate this person’s appendages (assuming the financial aspects are in order)? That doesn’t seem likely. [Body Integrity Identity Disorder](http://en.wikipedia.org/wiki/Body_integrity_identity_disorder) > [@](#): > > Today, no surgeons will treat BIID patients by performing the desired amputations. Some act out their desires, pretending they are amputees using prostheses and other tools to ease their desire to be one. Some sufferers have reported to the media or by interview over the telephone with researchers that they have resorted to self-amputation of a “superfluous” limb, for example by allowing a train to run over it, or by damaging the limb so badly that surgeons will have to amputate it. However, the medical literature records few, if any, cases of actual self amputation.[4] The one I remember from the news is one guy who managed to cut off his hand with a chainsaw, but he stuck it in the freezer as a memento, and then called the paramedics so he wouldn’t bleed to death. They followed the blood-trail and saved the hand also, and from what I remember (this is from at least a year ago) re-attached it back at the hospital over the patient’s continued objections, and then had him committed and medicated for delusions. I have been looking, but have not found any cites for it, and as it’s Thanksgiving, and I’m on the internet in the Caribbean, I’m not going to look much harder at the moment. The wiki page has some good citations at the bottom of the page. ---
**Author:** ![OpalCat](https://avatars.discourse-cdn.com/v4/letter/o/8edcca/32.png) [@OpalCat](https://boards.straightdope.com/u/OpalCat)\ **Post date:** [November 25, 2011, 9:15pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/35 "2011-11-25T21:15:58Z")
> [@OpalCat](#): > > I just texted my husband and he verified that yes, it increases the stress. I’ll ask him about the why later tonight and post what he says. OK I clarified with him what he had told me before. What he had been talking about was people who have, say, one leg amputated and they are still ambulatory. It’s less efficient to be moving around like that with the limb missing, and causes a higher strain on the cardiovascular system. So it’s not applicable to someone who has both legs amputated and is nonambulatory. He doesn’t think, however, that it would decrease the strain on the cardiovascular system to have the legs amputated. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [November 26, 2011, 1:50am UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/36 "2011-11-26T01:50:48Z")
#64 allis53ca Member Group: Members Posts: 666 Joined: 13-October 05 Gender:Male Country:rocky mountain high Spinal Injury Level / Relationship:c-5 Posted Today, 03:33 PM “If I were to go to a surgeon and say that I wanted my legs amputated; because I believed my quality of life would improve and I was suffering depression due to the “dead weight” of my paralyzed limbs, would I be able to have the operation? Even though I dealt with no actual real medical complication that made the amputation a viable option?”…yes, my legs were healthy enough to donate to tissue/vascular bank Ok, if you all can follow this, this is a copy of a post from the thread in question from the disability message board of which I am a member. This poster has in quotes a question that I posed to the participants in the thread regarding “convenience amputations”. This particular poster evidently underwent voluntary amputations himself, although (despite my queries) he hasn’t really explained the details surrounding his decision. This post is as much as he has said. And this puzzles _the hell_ out of me. This **can’t** be correct, on it’s face. It just cannot. Someone here must have the expertise and/or knowledge to set the record straight, one way or another. Right? \*I don’t really understand the relevancy of his amputated tissue’s health in regards to the question asked. 😕 ---
**Author:** ![SciFiSam](https://avatars.discourse-cdn.com/v4/letter/s/47e85d/32.png) [@SciFiSam](https://boards.straightdope.com/u/SciFiSam)\ **Post date:** [November 27, 2011, 2:47am UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/37 "2011-11-27T02:47:10Z")
> [@Ambivalid](#): > > #64 allis53ca > > Member > > Group: Members Posts: 666 Joined: 13-October 05 Gender:Male Country:rocky mountain high Spinal Injury Level / Relationship:c-5 Posted Today, 03:33 PM > > “If I were to go to a surgeon and say that I wanted my legs amputated; because I believed my quality of life would improve and I was suffering depression due to the “dead weight” of my paralyzed limbs, would I be able to have the operation? Even though I dealt with no actual real medical complication that made the amputation a viable option?”…yes, my legs were healthy enough to donate to tissue/vascular bank > > Ok, if you all can follow this, this is a copy of a post from the thread in question from the disability message board of which I am a member. This poster has in quotes a question that I posed to the participants in the thread regarding “convenience amputations”. > > This particular poster evidently underwent voluntary amputations himself, although (despite my queries) he hasn’t really explained the details surrounding his decision. This post is as much as he has said. And this puzzles _the hell_ out of me. This **can’t** be correct, on it’s face. It just cannot. Someone here must have the expertise and/or knowledge to set the record straight, one way or another. Right? > > \*I don’t really understand the relevancy of his amputated tissue’s health in regards to the question asked. 😕 Is it possible he’s making it up? ---
**Author:** ![doreen](https://avatars.discourse-cdn.com/v4/letter/d/858c86/32.png) [@doreen](https://boards.straightdope.com/u/doreen)\ **Post date:** [November 27, 2011, 3:35am UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/38 "2011-11-27T03:35:53Z")
> [@Ambivalid](#): > > \*I don’t really understand the relevancy of his amputated tissue’s health in regards to the question asked. 😕 I think what he means is that he didn’t have gangrene or circulatory problems which would be a medical reason for the amputation. ---
**Author:** ![brossa](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/brossa/32/3040_2.png) [@brossa](https://boards.straightdope.com/u/brossa)\ **Post date:** [November 27, 2011, 5:12pm UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/39 "2011-11-27T17:12:48Z")
> [@Ambivalid](#): > > [http://www.nhs.uk/Conditions/Amputation/Pages/Risks.aspx](http://www.nhs.uk/Conditions/Amputation/Pages/Risks.aspx) > > I’m not sure where you are getting your info, but these statistics seem to paint a different picture. But those statistics are an artifact of the underlying patient population, not of the procedure itself. If your diabetes or peripheral vascular disease has progressed to the point where you have gangrene and need an amputation, you have a higher risk of dying even with the amputation because you are at a high risk of dying, period. If overwhelming sepsis from some superbug has landed you in the ICU and shock has killed off your legs, etc. etc. You are poor protoplasm. Amputation is not typically performed on otherwise healthy people except in the case of trauma, in which event the complication rate is lower, as the reference notes. You would expect the best amputation outcomes in patients who were having purely elective procedures on an otherwise healthy limb: not because of acute trauma like a thresher accident or because of chronic or acute illness like diabetes or sepsis. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [November 28, 2011, 1:35am UTC](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676/40 "2011-11-28T01:35:36Z")
> [@doreen](#): > > I think what he means is that he didn’t have gangrene or circulatory problems which would be a medical reason for the amputation. That seems like a strange way of answering that question. Just because the tissue is healthy enough to donate after amputation doesn’t necessarily mean there was no preceding medical reason for the amputation. [Previous page](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676.md?page=1) [Next page](https://boards.straightdope.com/t/is-it-common-practice-to-offer-amputation-to-patients-recently-suffering-from-a-spinal-cord-injury/603676.md?page=3)