Xenomelia: la sindrome dell’arto straniero
Abstract
Xenomelia is a condition not yet recognised as a mental disorder and which conceptual basis is still under construction. The psychiatric literature refers to it as body integrity identity disorder (BIID). People with a disability desire describe a profound mismatch between their actual and their desired body, with respect to its shape or functionality. A frequently used word in their complaints is overcompleteness. People suffer from having four limbs, because they recognize themselves in the identity of an amputee. Those disability desires represent a neurological disorder, specifically a focal syndrome of the right parietal lobe. Clinical neurology identifies many syndromes of various misperceptions of body parts after damage to this site of the brain, ranging from a total neglect of the left side of the body to illusory reduplications and the loss of agency and ownership, to an active aversion or hatred of left-sided limbs. Morphometry shows that there is a reduced cortical surface area for the right inferior parietal lobule in people suffering a disability desire. The question to ask is whether conformance to disability desires can ever be ethically justified. This discussion has unfolded in connection with elective amputations offered to people with xenomelia in some countries. The framework of bioethical principlism indicates that the controversy is mainly about empirical issues.
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