Prosthetics and Ethics

2 Commentsby   |  10.04.10  |  Beginning of Scientific Psychology (Part III-A)

I had never heard of the concept of a phantom arm/leg before class on Friday, and it was quite surprising to me. Since the problem at hand has to do with perception and reality, my first thought was this, “Would a prosthesis help the individual at all? And what kind?” Growing up, I was around many individuals who lost limbs and choose to wear a prosthetic or a compression sock because my father was a specialist in orthotics and prosthetics. I remember watching my dad make plaster molds of legs and then bring them to fruition over the next several weeks while it was my big and exciting job to hammer the hard plaster out of the buckets he used. So several things went through my mind from what I know of the area (which is still very little). Would a prosthetic help? What kind? Is a multiple-function hydraulics leg (a C-leg) better than a general walking leg? What about special carbon fiber legs made for exercise and running? Would the ability to move your body more vigorously help? Who has the worst pain? Is it diabetics, or those who lost their limb from an accident, or a degenerative condition? And is there a large difference between below the knee/elbow patients and above the knee/elbow patients? Finally, phantom leg and arm pain isn’t just for patients who have lost a limb. I remember my dad seeing a girl my age (maybe 7 or 8 at the time) in his office, and as usual I asked how she had lost her leg. He told me that she was born without one, and the world finally showed itself to me as fallen. When researching the concept of phantoms, I discovered those born without limbs also experience phantom sensations, usually painful but not always.

Generally, what I found was that better fitting legs and compression socks could be a big help, but not as much as the mirror box or a virtual reality simulation. Heating or cooling a limb, massaging it, putting a prosthesis on, taking it off, exercising the limb, wearing a sock, etc. were ways to cope with the pain, but even the visual perception of the arm didn’t replace a real arm. It couldn’t perform the same functions. The hand is so complex, there are few good prototypes of a working prosthetic hand. There is no way to replace that visual perception of an intricately functioning hand except by creating an image of a working hand. Though I tried to find more information on the subject, most resources (like the Mayo Clinic and small clinics using the mirror-box system) either said the condition was largely untreatable or spoke of Ramachandran’s system. It seems prosthetics cannot make a perception so realistic that it becomes reality to the individual.

And I guess that is the catch with psychology. When the situation is unfavorable (having phantom pains) we seek to trick the mind and believe something that isn’t real (I have two arms now). However, if someone perceives that they are Jesus or that aliens will abduct them, then we seek to help individuals have an accurate perception of reality. But I must be fair, the first situation used an untruth so the mind would begin to send accurate signals (you don’t have phantom pains because you don’t have a phantom arm). Can anyone else think of situations that involve tricking the mind in order to create an accurate portrayal of reality? Or can you think of any ethical situations? What about individuals who perceive themselves as one gender but in reality are not? Do you correct the perception to meet the current reality? Do you trick the mind somehow? Do you change reality to meet the current perceptions? And how do ethics come into play?

2 Comments

  1. Hannah Hendrix
    12:39 pm, 10.04.10

    I really love that you brought this up! It is so interesting to me to think about how much of what we perceive is truly reality. How much of what we feel or know or even experience, as in the case of phantom limb pain, is really reality? How much are our perceptions influenced by other seeminly unrelated things around us? I do not know the answers to these type of questions, but I’m glad you brought them up for us to think about.

  2. Ian Robertson
    1:22 pm, 10.04.10

    I think it is very interesting that we can “fool” the brain into believing that a lost limb had been resurrected by use of vision and a mirror. It’s even more interesting because the patient is fully aware that the reflection is not the limb, but the brain doesn’t know. I think it bodes well for psychology as a form of medicine.

    Perhaps the best way to treat phantom limb is a combination of psychotherapy and prosthetics. I don’t it really violates ethics however, the patient is fully aware that the limb is not there, its the brain that hasn’t figured it out, and the patient isn’t being fooled by the mirror, the brain is.

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