The New York Times (registration required) has a lengthy article on people who feel compelled to have healthy limbs amputated -- a condition known variously as body integrity identity disorder, apotemnophilia or factitious disability disorder.

It's a subject I've written about many times in the past.

While accepting that psychiatric conditions often defy rational explanations, many of us who have lost limbs in traumatic circumstances feel horror and disgust towards anyone who actively seeks to have a healthy arm or leg removed.

Paddy Rossbach, president of the Amputee Coalition of America, puts it mildly:

"It's very difficult for people who have been through what they consider to be a devastating life experience to understand why anybody would want to mutilate himself in this way, especially when so many people are having tremendous problems with prosthetic fittings, or access to prostheses, and are living with pain every day of their lives."