The ethical permissibility to perform disabling surgeries on autonomous BID sufferers

Abstract: Body Integrity Dysphoria (BID) is a rare condition where a person has a desire to become disabled. This desire creates distress so intense that some request, and in a few cases have received, disabling surgery. The condition has raised debate, both concerning the BID suffers autonomy and whether the disabling surgeries conflict with the medical profession's obligations to respect patients’ autonomy, promote well-being and not do harm. In this paper, I argue that some BID sufferers plausibly possess the abilities required for medical decisionmaking, which means that they could be sufficiently autonomous to make a decision about disabling surgery. Further, I argue that if a BID sufferer is decision-making competent, and if disabling surgery is expected to have therapeutic benefits that outweigh the expected harms, and if no other treatments have proven effective for them, then it seems morally permissible for the medical profession to offer them disabling surgery as an experimental treatment.