medical ethics and toe removal

Totally hypothetical, but let’s just say I want some completely bizarre and unneeded surgery, such as, for example, having a toe removed. Can a doctor do this? Does it violate the “do no harm” thing? What if I really want only nine toes? What’s the ethics behind this?

By the way, I’m well aware of the fact that this is the
second thread of mine involving missing a toe, but I’d just like to point out that is no indicative of a pattern.

Well, I wouldn’t do it, but I’m sure some of my ‘colleagues’ would. And I might not blame them, given today’s craze for body modification, it’d be safer to have a doc do it than to have some obsessed type try to chop a toe off with an exacto knife. Of course, they could just start commitment proceedings, too. Self-mutilation is still grounds for a 24 hour hold in a locked psych ward. A lot would depend on the reason for the person wanting it done. If the person felt the toe was evil, and making them do bad things, I think it would be unethical to whack it off. At least prior to a heavy-duty psych evaluation.

But if they just wanted their little toes off to look more “cool” I wager they’d not have too much trouble finding a doc to take their money. Most health insurances sure wouldn’t cover it.

Qadgop, MD

Thinking about this one I think that a toe could be cut off… And even if there was no reason what so ever more then “I just feel like having a toe cut off” I"m sure that it could arranged when you look at money being thrown at certain doctors I’m sure that there much be some unethical ones who would do it. I think it just goes back to the fact that no human being is perfect and would do just about anything if enough tempation was presented.

Its not the slightest bit hypothetical. There have been a number of recent articles on the ethics of voluntary amputation of healthy limbs. I understand the AMA takes the position this is unethical but such surgeries have been conducted in england after patients threatenned to use a train to accomplish what the doctor refused to do. Patients are said to be happy with the results.

Here’s a Salon article about it:

http://www.salon.com/health/feature/2000/08/29/amputation/

My dentist has had similar requests. There have been people who requested having their old amalgam fillings removed - removed, not replaced. Their reasoning ranged from UFO radio broadcasts through their fillings to believing that they would die from poisoning.

In the end he couldn’t do it. Said he knew a dentist who would provide this service but wouldn’t recommend him. Also said that most people with old fillings eventually had to have them replaced with newer technology. When he offered that, they turned him down anyway.

From the Salon article:

“But there is also a gay community and groups for those turned on by leg braces, deformed feet and bunions.”

Bunions?

-Ben

I’d say it’s pretty unlikely you could get it done here, but south of the border, east of the border, who knows?

The Atlantic Monthly did an article back in December 2000 on so-called apotemnophiliacs and acrotemnophiliacs (those who are attracted to the idea of being an amputee and those sexually attracted to amputees, respectively.

You can find the full text here:

I found it a little disturbing but actually quite thought-provoking, especially the part about whether or not naming a new disorder makes people more likely to suffer from it.

or you could ask this guy…

not for the weak of heart…

he doesn’t call himself toecutter for lack of reason…
no, really, don’t go there if you might get sick easily
really

http://spc.bodymodification.com/galleries/other/amputation/

i warned you.

Would you need a toetruck to dispose of the severed appendage?

Sorry.

I think it was in Scotland. Worth noting that it was an entire leg in that case: you’d have serious difficulty trying to get hit by a train in such a way that you only lost a single toe.

There was a TV documentary in Britain a few months ago about men who want to be castrated. Most of them found a doctor to do it and the justification was usually that if they didn’t do it then some unqualified person would. It included an interview with a man (not a doctor) who performs castrations for people like this.