Abstract
N/a
Highlights
Body integrity identity disorder (BIID) is a rare condition in which an individual intensely desires the amputation or paralysis of one of their otherwise normal limbs
There is limited literature describing the ethical challenges and complexities in obtaining consent following self-amputation when replantation is a clinically viable option. This poses a question for the surgical team in the acute setting: in a non-psychotic, non-delusional and well-informed individual presenting with amputation, what is the ethically correct treatment decision?
A 30-year-old, right-hand-dominant transgender woman was brought to the emergency department following self-inflicted amputation of her right hand with a power saw
Summary
Body integrity identity disorder (BIID) is a rare condition in which an individual intensely desires the amputation or paralysis of one (or more) of their otherwise normal limbs. There is limited literature describing the ethical challenges and complexities in obtaining consent following self-amputation when replantation is a clinically viable option. This poses a question for the surgical team in the acute setting: in a non-psychotic, non-delusional and well-informed individual presenting with amputation, what is the ethically correct treatment decision?. The replanted hand showed signs of venous congestion requiring return to theatre By this time further psychiatric review and a second opinion by the psychiatric team indicated that the patient had sufficient insight into her condition and the consequences of her actions, with a diagnosis of BIID as a reason for her actions. The patient made a good recovery and was discharged the following week
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