Las fronteras de la autonomía en el ámbito clínicoel caso de los "wannabe".

  1. Alemany García, Macario
Revista:
Anuario de la Facultad de Derecho de la Universidad Autónoma de Madrid

ISSN: 1575-8427

Any de publicació: 2014

Títol de l'exemplar: Las fronteras del derecho biosanitario.

Número: 18

Pàgines: 231-248

Tipus: Article

Altres publicacions en: Anuario de la Facultad de Derecho de la Universidad Autónoma de Madrid

Resum

This article deals, from the point of view of bioethics, with the unusual case of some individuals who ask for the amputation of a healthy limb (the case of "wannabes"). It mainly takes into account the events described in the documentary "Whole", in particular two amputations performed by the surgeon Robert Smith on two "wannabes", a decade ago in Scotland. The article argues that all morally correct medical interventions must satisfy two conditions: the condition of medical responsibility and the condition of respect for autonomy. Smith's professional behavior appears to go beyond the limits of that responsibility turning him liable from misconduct. However, if it is accepted that the "wannabe" involved were competent to make decisions regarding their mental illness, the can said to share the accountability for the operation with Smith and, things considered, it could be defended that those amputations were morally correct. The article also holds that if the analogy between these assumptions and gender identity disorders is correct, the procedures for accepting a request for sex reassignment surgery should be taken as a model. Finally, the author stresses the importance of the public health perspective on this issue and is cautious as to whether that perspective might radically change the above findings.

Referències bibliogràfiques

  • Alemany, M., «El concepto y la justificación del paternalismo jurídico», Doxa. Cuadernos de Filosofía del Derecho, 28, 2005.
  • Alemany, M., «El paternalismo médico», en Gascón, González y Cantero (Coords.), Derecho sanitario y bioética. Cuestiones actuales, Tirant Lo blanch, Valencia, 2011, pp. 745-788.
  • Atienza, M. «Juridificar la bioética», en Isonomía. Revista de teoría y filosofía del Derecho, 8, 1998, pp. 75-99.
  • Bayne, L. y Levy, N., «Amputees by Choice: body Integrity Disorder and the Ethics of Amputation», en Journal of Applied Philosophy, 22, 1, 2005, pp. 75-86.
  • Barry, P. b., «The Ethics of Voluntary Amputation», en Public Affairs Quaterly, 26, n.º 1, 2012, pp. 1-18.
  • Cortina, A., «Ética de las profesiones», en AA. VV. Ética y legislación en enfermería, McGraw-Hill Interamericana, Madrid, 1997.
  • Culver, Ch. M. y Gert, b., Philosophy in medicine. Conceptual and Ethical Issues in Medicine and Psychiatry, Oxford University Press, Oxford, 1982, pp. 64 y ss.
  • De Lora, P. y Gascón, M., Bioética. Principios, desafíos y debates, Alianza Editorial, Madrid, 2008
  • Ehrsson, H., «The Concept of body Ownership and Its Relation to Multisensoy Integration», en Stein, b. E., The New Handbook of Multisensory Processing, Mit Press, 2012, pp. 775-792.
  • Elliott, C., «A New Way to be Mad?», The Atlantic Monthly, 283 (6), December, 2000, pp. 72-84.
  • Elliott, C., «Costing an Arm and a Leg. The victims of a growing mental disorder are obsessed with amputation», Slate, [post, en línea], julio, 2003, [22 de noviembre de 2013]. Disponible en la web: http://slate.msn.com/id/2085402
  • First, M., «Desire for amputation of a limb: paraphilia, psychosis, or a new type of identity disorder», Psychological Medicine, 35, 2005, pp. 919-928.
  • Frankfurt, H., «Freedom of the will and the concept of a person», en Journal of Philosophy, 68, 1970, pp. 5-20.
  • Furth, G., y Smith, R., Amputee Identity Disorder: Information, Questions, Answers and Re-comendations about Self-Demand Amputation, Authorhouse, London, 2000.
  • Garzón Valdés, E., «¿Es éticamente justificable el paternalismo jurídico?», en Doxa. Cuadernos de Filosofía del Derecho, 5, 1988
  • Gert, b., Culver, Ch. M. y K. Danner Clouser, Bioethics. A Return to Fundamentals, Oxford University Press, Oxford, 1997
  • Gracia, D., «Historia de la ética médica», en Vilardell, F., Ética y medicina, Espasa Calpe, Madrid, 1988, pp. 25-66.
  • Harmon, K., «What is Propofol and How Could It Have Killed Michael Jackson?», Scientific American, octubre, 2011.
  • Kant, I. «Sobre el tópico: esto puede ser correcto en teoría pero no vale para la práctica», en En defensa de la Ilustración, Alba Editorial, Madrid, 1999, pp. 241-289.
  • Money, J., Jobaris, R. y Furth, G., «Apotemnophilia: Two Cases of Self-Demand Amputation as a Paraphilia», The Journal of Sex Research,13 (2), 1977, pp. 115-125.
  • Müller, S., «body Integrity Identity Disorder (bIID)–Is the Amputation of Healthy Limbs Ethically Justified?», en The American Journal of Bioethics, 9, 1, 2009, pp. 36-43.
  • Nagel, Th., «What is It Like to be a bat?», en Philosophical Review, 83, 4, 1974, pp. 435- 440.
  • Porter, D., «The Healthy body», en Cooter, R. y Picstone, J. (eds.), Medicine in the Twentieh Century, Harwood Academic Publishers, Singapore, 2000.
  • Ramachandran, V., Mcgeoch, P., «Can vestibular caloric stimulation be used to treat apotemnophilia?», Medical Hypotheses, February 8, 2007, pp. 250-252.
  • Toulmin, S. Los usos de la argumentación, Península, barcelona, 2007.
  • Simón Lorda, P., «La evaluación de la capacidad de los pacientes para tomar decisiones y sus problemas», en Feito Grande, L. (ed.), Estudios de bioética, Dykinson, Madrid, 1997, pp. 119-154.
  • Wikler, Daniel: «Paternalism and the Mildly Retarded», en Sartorius, R., Paternalism, University of Minnesota Press, Minneapolis, 1987.