T. E. Quill and H. Brody, “Physician Recommendations and Patient Autonomy: Finding a Balance between Physician Power and Patient Choice,” Annals of Internal Medicine, Vol. 125, No. 9, 1996, pp. 763-769.

has been cited by the following article:

• TITLE: The Patient Requesting Amputation

  AUTHORS: Thomas M. Dunn, Ryan M. Moroze

  KEYWORDS: Amputation; Decision Making Capacity; Body Integrity Identity Disorder; Apotemnophilia; Somatoparaphrenia

  JOURNAL NAME: Open Journal of Medical Psychology, Vol.2 No.4, October 25, 2013

  ABSTRACT: Although infrequent, there are patients who present themselves to surgeons and ask that a limb be amputated. Generally, such patients fall into one of three categories. The first is those suffering from “Body Integrity Identity Disorder” (BIID), a condition in which individuals feel that one of their limbs is foreign to the rest of their body, and must be removed. The second category is Apotemnophilia, a fetishized desire to become an amputee to enhance sexual gratification. Such drive for sexual gratification may lead to requests for amputation. Finally, the third category is delusional beliefs secondary to severe mental illness that may compel an individual to seek amputation, or even attempt self-amputation. We present a fourth type of patient: the Global War on Terrorism veteran with a severely injured arm demanding amputation to fit in with others who use prosthetic devices. In this instance, the cause of injury was a motor vehicle collision. We speculate that our case is not the only one and that a fourth category of patient demanding amputation is emerging. Further study is needed.