Watching the debate on Thursday, I couldn't help but feel like both sides were missing one of the MAJOR issues with disorder classification. It was even touched upon by the first question asked by the audience. What are the monetary and political ramifications of calling apotemnophilia a disorder? With the health care debate red hot in Washington, what have we discussed that is MORE political than a controversial disease/disorder/ailment that could cost insurance companies millions of dollars if recognized as an official disorder.
Pinker does a good job touching on the "wannabes" and the trend for social disorder diagnosis rates to rise after they have been brought into a larger societal view. He stayed within his bounds though, and avoided discussing the implications of increased awareness for apotemnophilia. People abuse all systems, its a reality we live with, and this situation is certainly susceptible. How many people think the diagnosis rates will skyrocket if apotemnophilia is classified in the DSM as a disorder? I believe it will. I also believe if government health insurance is fully implemented, it will jump even higher! Not a massive jump, but it shall exist. While some of these people may truly have apotemnophilia, how many of them are being lumped into a broad-spectrum diagnosis when their problem is actually something entirely different? While the idea of amputating a leg may seem absurd to a rational being such as those of us reading this blog, I can think of plenty of reasons why an irrational person would want an amputation BESIDES the reasons prented as grounds for an apotemnophilia diagnoses.
The fact that the classification of apotemnophilia as a disorder is disputed, and health care is a hot political topic at the moment, is what makes this a clear cut case of biopolitics, and I think it would be interesting to see Stephen Pinker's musings into the larger societal role this disorder could play.
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An even better question your post leaves me with is that, if apotemnophilia does become a registered disease, what happens to the people who are mistakenly placed into the treatment schedule that follows with being diagnosed with the disease... legs are hard to replace! And what about the people who are judged incapable, or truly are incapable, of representing themselves for health-care decisions? How will they be treated if some whacked out doc starts diagnosing like crazy cause they're an "expert" on the disease?
ReplyDeleteEven if people are accidentally diagnosed with apotemnophilia I don't think they will immediately have an amputation scheduled. I can see how a broad spectrum would be beneficial to anyone who might possibly be living with this condition because therapy can begin with a psychiatrist who perhaps specializes in this type of disorder. The therapy might be a better measure of whether or not an amputation is truly what someone desires. Counseling could talk some of the people who are not full fledged wannabees out of this life changing surgery. Besides, if it is not classified as a disorder or something medical, how can the people who truly do suffer with the desire to be an amputee get the proper, safe treatment they need?
ReplyDeleteI agree with the last post. With regards to diagnosis, I think that it is important to note that classification makes things a hell of a lot easier. Earlier this year I went into the doctor with a tumor in my leg. The first doctor that I saw told me that it was nothing to worry about and that if I felt that I would be more complete (or happier) with the tumor removed, I could do so if I felt so inclined. I went into the surgeon and they removed it. Six weeks later, I called my surgeon to find out what the hold up was on my pathology report. It turns out that half of the 'best' oncologists and pathologists in the country thought I had cancer. The other half said I didn't have cancer. I spent MONTHS waiting for an answer and it just about killed me. The doctors couldn't decide what the call this amazing tumor so in the months I had been waiting, this cancer-ish thing progressed to the equivalent of stage three cancer. Seriously, man, I think that classification is a good thing. Dragging patients behind doctors who can't make up their mind isn't good for anyone. I think that by classifying things a great deal of people are helped in the long run (psychologically, physically, etc.)
ReplyDeleteIn response to what you said about classifying apotemnophelia as a disorder, I think that calling it, or anything for that matter, a disorder actually helps people. Apart from being able to claim something on insurance, calling something a disorder helps people beucase "people are conscious of the way that they are classified, and they alter their behavior and self conceptions in response to their classification" (Elliot 9). This allows people with disorders and other thoughts to associate with others that are like them. It allows for the AA meetings, and help groups. It would allow people to cope with this disorder, and I do not think that it would spread it, and I do not think that irrational people would voluntarily have an arm or a leg cut off. I do agree with you when it comes to the public health care debate, however. This is something that would be interesting to address.
ReplyDeleteGood Lord Tegan! That's awful. The issue--of course--isn't what you call it, but what it IS--and thank gods it wasn't..... (though this is a classic 'circulating reference' issue: medicine was trying to 'catch up' to where it can definitively name this thing (know it).) Better cell lines. Better imaging. Better studies on what grows how. Better histology--and finally we can say THIS 'isn't cancer.'
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