A Limb & A Moral Dilemma

So I’ll admit, I’ve recently done an extensive marathon of the series Chicago Med as I was in bed recovering from a bout with you-know-what (yes, it finally got me). One episode in particular caught my attention. In it, a patient is admitted into a psych ward and is restrained after attempting to cut off his own arm. The patient’s sense of self, according to Dr. Charles, the resident psychiatrist at the fictional medical facility, does not extend to his left arm. The patient’s sense of discomfort is extreme enough that not only does he beg for medical professionals to have his arm amputated, he’s willing to deal with the massive pain of doing so himself when that option is unavailable to him. You can watch the scene for yourself.

This presents a true dilemma. On the one hand, cutting of a limb is irrational and is causing pretty severe self-harm. But what if the patient is rational about everything else in their lives except this one thing? What if that one thing is resolved as per the patient’s desires, everything else will fall into place just fine?

Of course, there are therapeutic approaches that can be tried first: Teaching the patient to accept the arm, teaching him to ignore it, and teaching him to think of it as something else. If that fails, maybe it would help to tie it down, so that it would cause him less discomfort to have it as present on his body. And, of course, medicine. But what if none of these approaches work? What if the patient continues to suffer? What if by cutting off the arm, despite now missing a limb, the patient is indeed happier and in less distress? Is our need for the patient to have his arm because we think it’s better for his well-being actually more harmful for his well-being?

Now, what if instead of one arm, the patient needs to cut off all four limbs in order to feel okay? Does that change things?

Do we accept that perhaps some people are born a certain way that causes them to need to not have four limbs in order to avoid feeling great anguish? Yes, this is almost definitely a psychiatric condition, but if we have no other cure for it but to cut off the limbs, should we not proceed? Then again, how do we know for sure that if we cut all four limbs the patient will stop feeling this anguish? What if this ‘treatment’ works for some patients but does not work for others? What if some patients go on to have happy lives, without a limb, whereas others continue to suffer but now are also missing a limb and are full of regrets.

They knew the risks, they made a decision, they insisted on going forward…should the doctor have pulled the plug or respected their right to choose?

What if the doctor doesn’t respect the patient’s right to choose and the patient does more harm to themselves as result by trying to fix things on their own?

On the other hand, what if the doctors restrain the patient, and in a few years another treatment becomes available, or the psychological condition resolves?

Physicians take the hippocratic oath: “Do no harm.” But what does more harm, cutting off someone’s limbs, or the distress that leaving them causes the patient? To me, these are not easy questions to answer. Hence, it is a moral dilemma.

What do you think? Leave a comment below.

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[Photo by Ari Spada on Unsplash]

Who am I? I’m a writer with an overactive imagination and a random mind. Outside of Substack, you’ll find my work in publications such as Newsweek, WIRED, Variety, The Washington Post, The Guardian, Esquire, Playboy, Mashable, CNN Travel, The Independent, and many others. 

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