Body integrity identity disorder (BIID), previously called apotemnophilia, is an extremely rare condition where sufferers desire the amputation of a healthy limb because of distress associated with its presence. This paper reviews the medical and philosophical literature on BIID. It proposes an evidenced based and ethically informed approach to its management. Amputation of a healthy limb is an ethically defensible treatment option in BIID and should be offered in some circumstances, but only after clarification of the diagnosis and consideration of (...) other treatment options. (shrink)

Commentators on Schopenhauer’s philosophy have been at odds with one another concerning the signification of the “nothing” with which he closed the first volume of The World as Will and Representation in 1818, and how this relates to Schopenhauer’s proposition that the will is Kant’s thing-in-itself. This chapter contends that Schopenhauer’s works contain two conceptions of soteriological nothing: an early conception that is ontological and contrasted with the vanity of phenomenal life, and a later conception in which nothing is employed (...) as an apophatic denial of our epistemological categories. Schopenhauer sought to conceal the way in which his use and understanding of these concepts had changed by 1860 by appending a handwritten note to the close of the first volume that cited Isaak Jacob Schmidt’s translation of the Diamond-Sūtra, an explanation of the Buddhist concept of prajñāpāramitā. Examination of Schmidt’s treatise throws some light on the development of Schopenhauer’s metaphysics and soteriology between 1818 and 1860. (shrink)

sirIn a scholarly and thought-provoking paper, Clarke sets out to debunk the concept of “rational suicide” as nonsensical.1 His motivation in this is to undermine any support that the notion of rational suicide might give to a “categorical right to suicide”. If his enterprise were successful, however, it would go far beyond the “rights issue” and would have a profound impact on all arguments raised in support of euthanasia or physician-assisted suicide.Clarke's major thrust might be termed the argument from posthumous (...) ignorance. He begins with a claim that the process of making a rational decision involves the process of “gaining all possible facts and `imagining' all possible consequences”. He goes on to say that making a rational decision “in the consideration of life or death . . . would seem to be impossible”. It is “impossible” …. (shrink)

This chapter defends the view that Arthur Schopenhauer and Siddhattha Gotama were unquestionably pessimistic philosophers, insofar as they converged in locating the source of life’s suffering within the person rather than the external world. However, in the process of outlining the significant continuities between their respective phenomenological analyses of life’s suffering, this chapter detects an important divergence between them. This stems from their contrasting metaphysical positions and ultimately impacts upon their respective interpretations of the significance of life’s suffering, as well (...) as their proposed solutions to it. (shrink)

Many of the world’s mental health acts, including all Australian legislation, allow for the coercive detention and treatment of people with mental illnesses if they are deemed likely to harm themselves or others. Numerous authors have argued that legislated powers to impose coercive treatment in psychiatric illness should pivot on the presence or absence of capacity not likely harm, but no Australian act uses this criterion. In this paper, I add a novel element to these arguments by comparing the use (...) of the harm to others justification for coercive treatment in mental illness with its use in illness due to infectious disease, and suggest a double standard applies. People with mental illness are subjected to coercive treatments at levels of risk to others far, far lower than would precipitate coercive treatment in people with influenza. In effect, this element of mental health legislation represents an example of sanism—state-sanctioned discrimination against people with mental illnesses. (shrink)