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Transableism, disability and paternalism in public health ethics: taxonomies, identity disorders and persistent unexplained physical symptoms

Published online by Cambridge University Press:  02 April 2007

Robin Mackenzie
Affiliation:
School of Law, University of Kent
Stephen Cox
Affiliation:
Ivy Court Surgery, Kent

Abstract

Transableism is a term which refers to moving between states of being able and disabled by choice rather than by happenstance. Insofar as this may imply a choice to become dependent, claims upon the healthcare system are likely to result. In this piece we aim to explore some ethical and legal implications of such claims. In order to do so, we draw upon current debates over the place of autonomy, beneficence and paternalism in public health ethics, the taxonomy of disability and the status of persistent unexplained physical symptoms (PUPS).

Type
Research Article
Copyright
Copyright © Cambridge University Press 2007

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References

Amundsen, R. (2000) ‘Against Normal Function’, Studies in History and Philosophy of Biological and Biomedical Sciences 31: 3353.CrossRefGoogle Scholar
Anderson, J. and Lux, W. (2004a) ‘Knowing Your Own Strength: Accurate Self Assessment as a Requirement For Personal Autonomy’, Philosophy, Psychiatry & Psychology 11: 279–94.CrossRefGoogle Scholar
Anderson, J. and Lux, W. (2004b) ‘Accurate Self Assessment, Autonomous Ignorance and the Appreciation of Disability’, Philosophy, Psychiatry & Psychology 11: 309–12.CrossRefGoogle Scholar
Bayne, T. and Levy, N. (2005) ‘Amputees by Choice: Body Integrity Identity Disorder and the Ethics of Amputation’, Journal of Applied Philosophy 22: 7586.Google Scholar
Berger, B. (2005) ‘Nonpsychotic, Nonparaphilic Self-amputation and the Internet’, Comprehensive Psychiatry 46: 380–83.CrossRefGoogle ScholarPubMed
Biggs, Hazel and Mackenzie, Robin (2000) ‘Viagra is Coming! The Rhetoric of Choice and Need’, in Freeman, Michael and Lewis, Andrew, (eds.) Law and Medicine. Oxford: Oxford University Press, pp. 341–61.Google Scholar
Brazier, Margaret (2000) ‘Does Medical Law Have a Future?’ in Hart, D. (ed.) Law’s future(s). Oxford: Hart Publishing, pp. 371–89.Google Scholar
Brazier, Margaret (2006) ‘Do No Harm: Do Patients Have Responsibilities Too?’, Cambridge Law Journal 65: 397422.Google Scholar
Callahan, Daniel and Jennings, B (2002) ‘Ethics and Public Health: Forging a Strong Relationship’, American Journal of Public Health 92: 169–76.Google Scholar
Carson, A. et al. (2000) ‘Do Medically Unexplained Symptoms Matter? A Prospective Cohort Study of 300 New Referrals to Neurology Outpatient Clinics’, Journal of Neurology and Neurosurgical Psychiatry 68: 207.CrossRefGoogle Scholar
Childress, J. et al. (2002) ‘Public Health Ethics: Mapping the Terrain’, Journal of Law, Medicine and Ethics 30: 170–78.Google Scholar
Clapton, J. (2003) ‘Tragedy and Catastrophe: Contentious Discourses of Ethics and Disability’, Journal of Intellectual Disability Research 47: 540–55.CrossRefGoogle ScholarPubMed
Corker, M. and Shakespeare, Tom (2002) Disability/Postmodernity: Embodying Disability Theory. New York: Continuum.Google Scholar
Danermark, B and Gellerstedt, L (2004) ‘Social Justice: Redistribution and Recognition – a Non-reductionist Perspective on Disability’, Disability & Society 19: 339–53.CrossRefGoogle Scholar
Department of Health (2002) The Chief Medical Officer’s Working Group’s Report on Chronic Fatigue Syndrome/Myalgic Encephalitis. London: Department of Health.Google Scholar
Ehrsson, H. et al. (2005a) ‘Neural Substrate of Body Size: Illusory Feeling of Shrinking of the Waist’, Public Library of Science Biology 3: 412–20.Google ScholarPubMed
Ehrsson, H. et al. (2005b) ‘Touching a Rubber Hand: Feeling of Body Ownership is Associated with Activity in Multisensory Brain Areas’, Journal of Neuroscience 25: 10564–73.CrossRefGoogle ScholarPubMed
First, M. (2004) ‘Desire for the Amputation of a Limb: Paraphilia, Psychosis or a New Type of Identity Disorder’, Psychological Medicine 35: 919–28.CrossRefGoogle Scholar
Furth, G. (2000) Amputee Identity Disorder: Information, Questions, Answers, Recommendations About Self-demand Amputation. New York: Authorhouse.Google Scholar
Gard, M. and Wright, J. (2005) The Obesity Epidemic: Science, Morality and Ideology. London: Routledge.CrossRefGoogle Scholar
Goodlad, R. and Riddell, S. (2005) ‘Social Justice and Disabled People: Principles and Challenges’, Social Policy & Society 4: 4554.CrossRefGoogle Scholar
Grill, K. and Hansson, S. (2005) ‘Epistemic Paternalism in Public Health’, Journal of Medical Ethics 31: 648–53.CrossRefGoogle ScholarPubMed
Hayry, M. (2006) ‘Public Health and Human Values’, Journal of Medical Ethics 32: 519–21.Google Scholar
Holm, S. (2006) ‘Self Inflicted Harm: NICE in Ethical Self Destruct Mode’, Journal of Medical Ethics 32: 125–6.Google Scholar
Hughes, B. and Paterson, K. (1997) ‘The Social Model of Disability and the Disappearing Body: Towards a Sociology of Impairment’, Disability & Society 12: 325–40.CrossRefGoogle Scholar
Johnston, J. and Elliott, C. (2002) ‘Healthy Limb Amputation: Ethical and Legal Issues’, Clinical Medicine 2: 431–5.CrossRefGoogle Scholar
Jordan, J. (2004) ‘The Rhetorical Limits of the Plastic Body’, Quarterly Journal of Speech 90: 327–58.Google Scholar
Mackenzie, R. (2006) ‘Addiction in Public Health and Criminal Justice System Governance: Neuroscience, Enhancement and Happiness Research’, Genomics, Society and Policy 2: 92109.Google Scholar
Mackenzie, R. and Cox, S. (2007) ‘Transableism, Autonomy. Self Demand Amputation and Harm: the Doctor’s Dilemma’, Paper delivered at Interrogating Embodiment, a conference at Keele University, December 2005. Medical Law Review forthcoming.Google Scholar
Manchester Evening News (2005) ‘Scandal of the Cancer Fakers’ Manchester Evening News 21 April: http://www.manchesteronline.co.uk/men/news/health/s/155/155636_scandal_of_the_cancer_fakers.html.Google Scholar
Mayou, R. and Farmer, A. (2002) ‘Functional Somatic Symptoms and Syndromes’, British Medical Journal 325: 265–68.CrossRefGoogle ScholarPubMed
Meekosha, H. (2004) ‘Drifting Down the Gulf Stream: Navigating the Cultures of Disability Studies’, Disability & Society 19: 721–33.Google Scholar
O’neill, O. (2002a) ‘Public Health or Clinical Ethics: Thinking Beyond Borders’, Ethics & International Affairs 16: 35–45.Google Scholar
O’neill, O. (2002b) Autonomy and Trust in Bioethics. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Ravilous, K. (2005) ‘How the Brain Builds Its Image of the Body’, Guardian, 29 November.Google Scholar
Salmon, P. and Peters, S. (2002) ‘Doctors and Social Epidemics: the Problem of Persistent Unexplained Physical Symptoms, Including Chronic Fatigue’, British Journal of General Practice 32: 355.Google Scholar
Sharpe, M. (2002) ‘Unexplained Symptoms and Syndromes’, Clinical Medicine 2: 501–4.Google Scholar
Silvers, A. (1998) ‘A Fatal Attraction to Normalising: Treating Disabilities as Deviations From “Species-typical” Functioning’ in Parens, Eric (ed.) Enhancing Human Capacities: Conceptual Complexities and Ethical Implications. Washington DC: Georgetown University Press, pp. 95–123.Google Scholar
Silvers, A. (2003) ‘On the Possibility and Desirability of Constructing a Neutral Conception of Disability’, Theoretical Medicine 24: 471–87.Google Scholar
Smith, G. (2001) ‘Reflections on the Limits of Epidemiology’, Journal of Clinical Epidemiology 54: 325–31.Google Scholar
Stirrat, G. and Gill, R. (2005) ‘Autonomy on Medical Ethics After O’Neill’, Journal of Medical Ethics 31: 127–30.CrossRefGoogle ScholarPubMed
Templeton, S. (2006) ‘Drug May Heal Livers of Chronic Alcoholics’, Sunday Times, 24 September: http://www.timesonline.co.uk/newspaper/0,,176-2372358,00.html.Google Scholar