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Strategies & Market Trends : Piffer OT - And Other Assorted Nuts -- Ignore unavailable to you. Want to Upgrade?

To: Janice Shell who wrote (16761)	1/30/2000 5:53:00 PM
From: Jorj X Mckie	Read Replies (1) \| Respond to of 63513

Oops...(second Oops in one day).... Hi Janice, how are you?....long time.

To: Janice Shell who wrote (16761)	1/31/2000 7:33:00 AM
From: long-gone	Read Replies (3) \| Respond to of 63513

Well, here's another[WEIRD] one I have to post somewhere & get everyone's thoughts on: Investigation after limbs amputated on demand Scots hospital admits two men paid to have healthy legs removed JENNIFER TRUELAND Health Correspondent A HOSPITAL has admitted taking money for amputating the healthy limbs of psychologically disturbed men who had nothing physically wrong with them. An investigation has been held and a full statement is due to be released today prior to a meeting of the hospital?s health board tomorrow, at which the inquiry?s results will be discussed. Falkirk and District Royal Infirmary cut off a lower leg from each of two private patients ? one from England and one from Germany ? who had been turned away by doctors across Europe. The men apparently had body dysmorphic disorder, a psychological condition where they focused on a perceived imperfection which overwhelmed the rest of their life. But the symptoms also resemble apotemnophilia, a condition where people scheme to get one or more limbs amputated in order to obtain sexual gratification. Very few doctors worldwide are prepared to amputate healthy limbs for psychological reasons, which sends many patients to seek "back-street" treatment. Last year, an unlicensed doctor, John Brown, was jailed for 15 years in the United States after amputating the leg of Philip Bondy, 79, whose lifelong ambition had been to lose his left leg. Brown, who buried the leg in the desert to hide the evidence, was jailed for second degree murder after Mr Bondy developed gangrene and died following the œ6,000 operation in Mexico. There has been no suggestion that the operations carried out in Falkirk were sex-related. Nonetheless they are highly controversial and it is understood that they are not performed elsewhere in Europe. No disciplinary action is likely because the operations were deemed clinically appropriate and the surgeon followed the correct procedures in consulting his managers. The operations were performed in National Health Service theatres using NHS staff, but the men paid the trust as private patients. Similar procedures would cost about œ3,000. The surgeon in Falkirk was asked to amputate the lower leg of a man from England in 1996. The man had apparently reached the point where he felt that he could not go on if the limb was not removed. The surgeon was interested in proceeding with the surgery after reading psychiatric reports on the man, which said he had body dysmorphic disorder. The doctor consulted the hospital?s then medical director Douglas Harper, also a surgeon, and took the advice of professional bodies, who said the surgery could be clinically justified, but that the trust management should be consulted. The trust?s chief executive, Margaret Duffy ? now finance director at Lothian University Hospitals NHS Trust ? gave it the go-ahead without approaching the trust board or its chairman, Ian Mullen. In September 1997, the patient had a lower leg amputated. Although the operation was carried out privately, it is understood that the surgeon did not take a fee. The surgeon?s fee for such an operation would have been œ589, according to literature from the health insurers BUPA. The remaining cost would come from theatre time, paying other staff and the hotel costs of a hospital stay which could have been up to ten days. Subsequently another patient, this time from Germany, approached the surgeon, having heard that he was willing to perform the procedure. Again the surgeon consulted the medical director but not the chief executive. Again the board was not informed. The procedure was carried out early in April 1999, shortly after the hospital became part of the Forth Valley Acute Hospitals NHS Trust and the management team changed. The new board and new chief executive were not told. Last summer, the surgeon approached the new chief executive, Jim Currie, to say that he was involved in assessing a third patient, an American, who wanted a leg amputated. He told Mr Currie about the two previous procedures. The chief executive consulted the chairman and permission was refused, pending an inquiry by the newly-formed trust ethics committee. The committee is believed to have completed its investigation and that permission to carry out similar operations will be refused. A trust spokesman said: "It is true that the trust?s ethics committee has been conducting an inquiry into body dysmorphic disorder operations at Falkirk and District Royal Infirmary." Surgery is not recommended by most doctors who specialise in body dysmorphic disorder. Dr Katharine Phillips, the director of the Body Dysmorphic Disorder and Body Image Programme at Butler Hospital in Providence, Rhode Island, says plastic surgery is almost never helpful for sufferers. The usual treatment is anti-depressant medication and psychotherapy. The surgeon has not been named, nor have the patients. scotsman.com