Controversial Medical Procedures

boyPetri

Some very controversial medical procedures are available – if you know where to look.

Consider amputee fetishists. In the psychiatric literature, the term is apotemnophilia. In a different literature, the term is wannabe. These are people who suffer from a rare condition that makes them desperately anxious to have a healthy limb removed. It’s not even clear whether the condition itself stems from a form of body dysmorphic disorder (a mental disorder in which a normal-appearing person is either preoccupied with some imagined defect in appearance or is overly concerned about some very slight physical anomaly), or a variation on the sexual amputee fetish, where the subjects are so aroused by amputees that they wish to become amputees themselves. Just a few years ago, there were two surgeons willing to amputate the limbs of healthy individuals.

Dr. John Ronald Brown, of San Diego, California had been a respected surgeon, who had made major advances in the techniques of sex-change surgery. But in 1977, Brown was charged with incompetence and lost his license. Brown relocated to Tijuana, Mexico, where on May 9, 1998, he removed the left leg of an apotemnophiliac who died two days later, in a local Holiday Inn, of gangrene. Brown was convicted of grievous bodily harm in a San Diego court, and sentenced to 15 years to life. The sentence was upheld, on the grounds that even though the surgery had been performed in Mexico, the arrangements had been made in the United States.

In Scotland, Dr. Robert Smith had performed surgery on two patients (in 1997 and 1999) with apotemnophilia, and was preparing for a third case when the hospital where he had performed the surgery withdrew its approval. To justify medical amputation, Smith said that apotemnophilia does not seem to be responsive to any psychiatric treatment, and patients have been known to cause themselves serious injury, using tourniquets, dry ice, or in one reported case a shotgun.

“If your [body part] causes you to sin …”

While it’s nearly impossible to find someone to amputate a healthy limb, it’s easier for men who want to be castrated to find someone to help out. Dr. Felix Spector, featured on the Sundance Channel’s 2003 film American Eunuchs, maintains an office on Pennsylvania Avenue, in Philadelphia. While Dr. Spector no longer performs castrations himself, he still handles all bookings and payment details. Although castration might be considered ethically questionable by some, President George W. Bush, while Governor of Texas, signed a law allowing judges to offer castration as an alternative to other forms of punishment for sex offenders.

The Clone Wars, or “Send in the Clones”

If subtraction is a question in medical morality, multiplication is a bigger ethical challenge. One of the most challenging issues of the moment is human cloning. While the United States pushed through a United Nations non-binding resolution against human cloning, many nations (for scientific progress and economic advantage) are more than glad to support cloning.

So far, documented human cloning has been limited for use in stem cell research. Two Seoul National University scientists, Hwang Woo Suk and Moon Shin Young reported in the journal Science that they had successfully cloned human cells – but these clones were used only for the extraction of stem cells, and were not intended to lead to the development of a human being.

In contrast, a sect called the Raelians (whose founder, French journalist Claude Vorilhon, claims that on December 13, 1973, he was contacted by a visitor from another planet, and asked to establish an embassy to welcome the extraterrestrials back to Earth) claims to have successfully cloned humans. Dr. Brigitte Boisselier, a Raelian Bishop with degrees in physical and biomolecular chemistry, sent a letter to the United Nations that began: “At the upcoming 59th session of the General Assembly you will decide whether I am a criminal or not. By the same token you will tell the 13 cloned children that are alive today and all the future ones, whether they are the result of a crime or of the desire of loving parents. You will tell these belated twins whether it is criminal to be a twin or not.”

While the Raelians haven’t proven their ability to clone humans, through their company CLONAID, they offer to clone you, your child, or your pet. And although they choose not to reveal their exact location (and “decided to pursue [their] human cloning project in another country where human cloning is legal”), the Raelians can be reached by email, and will take orders for cloning services and will accept financial investments.

For another source of reproductive cloning, consider Dr. Panos Zavos of Lexington, Kentucky. Although Dr. Zavos can’t claim to have 13 healthy cloned children to his credit, he claims to have succeeded in taking DNA from two dead people (an 11-year-old girl and a 33-year-old man) and implanting it into living eggs that subsequently divided in the laboratory to form embryos. So far, however, attempts to implant the cloned human embryo in a woman’s womb have been unsuccessful.

If Dr. Zavos isn’t ready to offer cloning, he can, and does, provide preimplantation genetic diagnosis of IVF embryos. Since it’s assumed that an embryo with 21-trisomy or an XYY genotype would be promptly discarded, this procedure raises ethical questions. But, beyond that, genetic diagnosis can be used to determine the infant’s sex, which might be used for “family balancing,” and which raises ethical questions around discarding embryos based solely on whether they are the sex preferred by the parents.

Less Babies, Not Less Controversy

In January 2005, a 67-year-old Romanian woman gave birth to a healthy baby, becoming the world’s oldest mother, and started an ethical, medical and religious debate about fertility treatment for older women. Romania’s Orthodox Church gave the birth its blessing, but the head of Romania’s medical ethics board said such a controversial procedure should have been debated before conception.

Changing Morality

Consider Egas Moniz, who in 1949 won the Nobel Prize for developing the technique now known as prefrontal lobotomy. At the time, lobotomy was as good a technique as could be had, because chlorpromazine wasn’t developed until the 1950s. But today, except in extreme cases, the technique would be considered barbaric. Similarly, in the mid-20th century, the practice of sterilization of the mentally ill or disabled was considred acceptable, good, and wise. The reality is that advancements in medicine and changing mores mean that judgements of the appropriateness, morality, or ethics of some medical procedures may evolve over time.

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