Saturday 1 September 2007

Propos impertinents (2007)

From The Philosopher, Volume LXXXXVII No. 2


The French philosopher known as Alain (born Emile-Auguste Chartier in 1868, died 1951) lived in Mortagne in Normandy, a small market town in which  a statue and small museum are a testimony to his continued standing in French intellectual life. During his life, he wrote many brief pieces attacking the establishment of his day ­ clerics, academics, politicians - and Brenda Almond has selected and translated four of these for The Philosopher, drawn from his Propos impertinents, written between 1921 and 1936.

Propos #1
8 December, 1922

Bucephalus - Find The Pin 

When a small child cries and refuses to be comforted, the child's nurse often makes ingenious assumptions about the young person's character, his likes and dislikes; she even summons up heredity to help, and claims she can already recognise the father in the son. These attempts at psychology continue until the nurse discovers what has really caused it all: a pin.

When the famous horse Bucephalus was presented to the young Alexander, there wasn't a horseman who could keep his seat on the wonderful creature. An ordinary person would have said: 'That's a wicked horse.' But Alexander looked for the pin, and he soon found it; he noticed that Bucephalus was terrified of his own shadow; and because his fear made his shadow jump too, this just kept the situation going. But Alexander pointed Bucephalus' nose towards the sun, and by keeping him going in that direction, he managed to calm him and tire him out. So Aristotle's pupil already knew that we can't control our feelings as long as we don't know their really causes.

Plenty of men have overcome their fear, and for good reasons; but someone who is afraid doesn't listen to reasons; he is listening to his own heartbeat and the pounding of his blood. The pedant reasons from danger to fear; the emotionally-charged individual reasons from fear to a danger. Both of them want to be reasonable, but both of them are making a mistake. The pedant, however, is doubly mistaken: he doesn't know the real cause and he doesn't understand the other person's mistake. A person who is afraid invents some danger in order to explain his real well-founded fear. Now the least little surprise can frighten someone when there isn't any danger at all, for example, a gun fired close to you when you aren't expecting it, or even just somebody's sudden unexpected appearance. [Napoleon's genera] Masséna took fright at a statue on a poorly-lit staircase and took to his heels and fled.

A man's impatience and bad temper are sometimes due to the fact that he's been standing up too long; don't reason with him about his temper, but offer him a seat. Talleyrand, in saying that manners are everything, was saying rather more than he realised. In his concern not to cause other people trouble, he was looking for a pin and he ended up by finding it. All diplomats today have a pin placed to prick them through their clothes ­ it's the source of Europe's complexities; and everyone knows that when you get one child crying, it makes the others cry too; what's worse, they're crying because of the crying! Nurses, following their professional instinct, lay the child on its stomach; immediately there's a change of behaviour and a new regime; here's a way of persuading that doesn't aim too high.

The evils of 1914 happened, I believe, because important people were taken by surprise; and this made them afraid. When a man is afraid, anger is not far behind; irritation follows fright. It's not very nice for a man to be brusquely called away from his leisure and his rest; he often changes and changes a lot. Like a man whose been rudely awoken, he is too wide awake. But never say that men are wicked; don't ever say that's their nature. Look for the pin. 

*Alain, Propos sur le bonheur, Folio Essais no. 21. Edition Gallimard, 1928. pp. 11-13

Propos #54

11 April 1906

The Wisdom of the Voters  

When I said I was a radical, a serious-looking man said to me: 'What does 'radical' mean? It's just a word, a label, nothing more. I understand what it is for someone to be a monarchist or a socialist, but thereís no such thing as radicalism.'

I replied: 'To my mind, radicalism is something that is quite precise, and it's easy to define. Essentially, it's a political doctrine; it's only secondarily that it's an economic theory, and that's where you could attack it; for as far as property, work, taxes, in a word, the real business of the legislator, are concerned, it's opportunistic. But the political doctrine is perfectly solid. You could call it pure democracy.

Human beings, although they are unequal in practice, are equal in law ? that's the principle involved. The law and the authorities must constantly battle against inequality, which natureís laws ensure is constantly reborn, and in a thousand different forms.

Always, and whatever happens, there is one sure way to remedy this: that is to keep on improving universal suffrage, i.e. government of the people by themselves.

An educated populace, which deliberates and debates; a people enlightened and informed by experts and by their representatives, but not governed by them ? no, governed by itself - that's the ideal. And it's worth working to that end because we're still a long way away from it. All the powerful forces in society, the aristocracy, religion, wealth, authority, almost always get together and work to deceive the voter, to deceive the person they have elected, and to resist by cunning the will of the majority.

The radical takes on himself a double task; first to find out to the best of his ability, and on every issue, what the majority wants; then to keep an eye on the authorities and call them to account.

If you now ask the radical where this system is taking us, youíre asking too much of him. The republic will be whatever the majority want. Every other kind of justice is tyranny.

Alain, Propos impertinents, (1906-1914), Mille et une nuits, Departement de la Librarie Artheme Fayard, septembre 2002. pp. 13-15.

Propos #2063 
11 November, 1911

Too Long!

All those parliamentary speeches, all those reports people distribute, all the articles you read, all those works you pay so much for, they're all too long. Where does this dreadful word-mongering come from? Where did our brightest schoolkids learn to say in three pages what could be said in one? I dont know.

Our classical authors don't ramble on. Pascal, Moliere, La Rochefoucauld, La Bruyere, Voltaire, Rousseau, say a lot in a few words. Even our tragic poets make a perfectly natural attempt to compress their thought into a single line; all good poems, all the ones you remember and quote, are remarkable for what you might call their density; they pack a lot of meaning into a small space. Even Hugo, who is sometimes long-winded enough to be boring, is, in his best passages, more succinct than anyone. In short, the model that grips and impresses the student is always something that is tightly presented and rich in meaning. How is it that all, or nearly all, of those who have worked the most along those lines finally come round to developing, extending, expanding, repeating, and drawing things out? For every speech is too long, every article is too long, every book is too long.

Scholarly custom, no doubt. You dont usually train pupils to present a point that has been made in two lines in one line, as one should. On the contrary, you tell them to expand it; because their work has to have a certain length. A teacher who awarded the prize for an essay of four lines would be laughed at. So the original statements are forgotten. They are added to rather than slimmed down; three sentences are generated out of one; words are deployed like an army, to occupy as much ground as possible. It's just the opposite you should be aiming at.

You have to take account, too, of the laziness of the reader, who skims through, and expects to understand the whole thing if he understands one sentence in ten picked up at the gallop. On the other hand, the two failings are complementary; the verbose author creates a lazy reader. Similarly, the one who is succinct wakes the readers attention. When we had a radical opposition, it created a rhetoric of attack which could destroy a government minister in three sentences. But once in power these radicals are more long-winded and heavy-handed.

The reason is, perhaps, that you have to be long-winded if you want to trick and numb your opponent; the defence strategy is always to draw things out rather than launching the shortest possible attack. The first of these methods produces results; the other just intimidates. Now all our radical thinkers are preparing themselves for public office; so they have to be weighty and serious to the point of boredom. Let's not forget either the prejudices of historians, who want to go back to the year dot; this useless history is a dead weight on all speeches and all reports. You can't propose raising taxes on cotton or on salted meat by a couple of centimes without giving the history of taxes, or indeed of tax in all countries. This pedantry of the diplomat and the historian has to be killed with ridicule.
*Alain, Propos impertinents (1906-1914), Mille et une nuits, Departement de la Librairie Artheme Fayard, September 2002. p. 61. 

Propos #2795

15 November, 1913

Two Worlds

A workman had some pretty strong things to say about teaching methods: The kids are in class; they're being told what a storm is, and what lightning is. Just then, there's a flash of light and the sound of thunder; but they quickly shut the windows and draw the curtains. Everyone laughs. And everyone also senses the symbolic force of this story. All that talking about things inside four walls, when outside you have the things themselves, that would provide us with such good lessons!

But you need to see both sides of the question. On the one hand, you have to know how to profit from vivid and striking real-life experiences that open the door into the child's mind; it is sometimes necessary for the lesson to follow the experience. For example, a lesson on compassion will be better absorbed and take root more deeply if it follows image of misery that makes you cry. Or a lesson on prudence, following a terrible accident; or on sobriety about an unpleasant drunkard. For it is quite rare for a child's attention, as shifting as a bird, to stop for a moment on anything. Grasp the opportunity; use the thunder.

Our teachers all stopped at this point. But its only the first moment, the purely instinctive moment of attention. Undoubtedly it is the key characteristic of man on this planet not to pay attention to the thunder, and instead to look at things that the ear doesn't hear and the eye doesn't see, such as the law of gravity, the movement of the stars, the relationship of volt and ampere, or the indirect measurement of the arc of the meridian, using triangles.

Because, in fact, practical experience rains down on the whole world; everyone gets equally wet, yet not equally well informed. The real task of the human being is to go back over these things, not just considering those that sparkle or burn. And that's what the cat or the dog cant do; they only live by imagination. There's a moment when a young pupil doing arithmetic tries hard to work things out for himself, and despises rote learning, which is so good at giving the answer without the reasons. You have to help him pass from the animal to the human condition, by getting him to see, for example, the rigour of thought for its own sake. In short, the child has to come to despise trite stories, showy experiences, the cinema, eventually all the games of imagination.

It is necessary to move on from imagination to understanding; that's where a problem comes in useful; and it's the second moment. And, finally, the child has to appreciate the leap he's made and to separate as if into two worlds, the playground and the classroom. He's pretty happy with that; he isn't so keen on childhood; he would like to escape it. The child will despise you, teacher, if you let him please himself.

*Alain, Propos impertinents (1906-1914), Mille et une nuits, Departement de la Librairie Artheme Fayard, September 2002. p. 61.

Review: Praised Be Our Lords (2007)

From The Philosopher, Volume LXXXXV No. 2

Régis Debray, (right) being arrested in 1967 at Camiri in Bolivie (Credit: 

A Political Education

Reviewed by Colin Kirk

Praised be our Lords : A political education by Regis Debray (Loués soient nos seigneurs. Une education politique trans. John Howe), Verso London/N.Y 2007 UKP 19.99 IBSN: 978-1844671403 

A pupil of Althusser, Debray loved his mentor but ignored his guidance. Theoretical practice of Marxism, historical inevitability dehumanised, and academia generally, were not his milieu. Indeed, he craved experience of revolution, sought political involvement. He was not to be disappointed.

During the early years of the Cuban revolution, Debray was a familiar of Castro, who was to use him as link man with Che's Bolivian mission. He spent four years in prison after that tragic fiasco. He served a much longer sentence as political advisor to Mitterrand. Between the two he fitted in Allende's brief presidency of Chile and its demolition by Pinochet and the CIA. He advises anyone keen on academic eminence not to follow this route. He means he hasn't been summoned to the Ecole Normale Supérieure like Althusser, or the Collège de France like Foucault, a contemporary of his as a prodigy of Althusser. Nor is he likely to be!

This is the second part of Régis Debray's Autobiography Le temps d'apprendre à vivre, published by Gallimard in 1996. The first part Les masques, une education amoureuse 1988 and the third, Par amour de l'Art, une education intellectuelle 1998, are not indispensable. This volume is. Before explaining why, it is necessary to sweep away the humbug, of which there is not a little.

The cover of the paperback edition of Praised be Our Lords has a monotone of Debray's face uncannily like Che's on the Cape/Lorrimer edition of Bolivian Diary, Ernesto 'Che' Guevara, Introduction by Fidel Castro, London, 1968. This is the famous Christ like image of the dead Che produced by the CIA, which did almost as much to iconise him as the 
ubiquitous image fortuitously found behind a shot of Sartre and de Beauvoir on their eulogising trip to Havana in 1960: a quartet of media personalities? Like Althusser, Debray does have a tendency to back modestly into the limelight.

Moreover, Debray's ironic title and opening sentence I loathe public life and politicians have to be a shade deceptive. Fairly recently Chirac appointed him to the commission on secularity, under the chairmanship of Bernard Stasi, Médiateur de la République, which resulted in the head scarf ban. Debray is director of the European Institute of the History of Science and Religion, which aims inter alia to be a check on mis-educational aspects of Media bombardment, and Professor of Philosophy at the Université de Lyon-III.

Nor will he make the Académie Française. These elevated positions are in the gift of the President of the Republic, one Sarkozy no less. In the first round Debray advised voting for Bayrou, in the second for Royale, even wrote despairingly of the shift in French politics to the extreme right. And anyway, French literati criticise Debray for slipshod writing, lack of structure and so on.

In Praised be Our Lords, Debray defines by experience and direct reflection. The structure of the book is a triptych within a proscenium arch. Enough to satisfy the most refined literary tastes. But disciples of Althusser are expected to ape his perfection of French elegance of expression, pellucid prose and so on.

Debray has a somewhat Surrealist stream-of-consciousness style, which John Howe captures admirably. The translation is better than faultless, it is great writing.

Now, with all the easy sarcasm out of the way, which French reviewers revelled in ten years ago, let's get down to the serious business of consideration of why this book bears comparison with Machiavelli's The Prince, which Russell described as a handbook for gangsters. His grandfather, British Prime Minister 1846-52 and 1865-6, would have known better. He too had practical experience rather than theoretical wisdom. The nearest Anglo-Saxon (wonderful Gallic portmanteau word) parallel to this book is Hobsbawm's Revolutionaries, an exclusively academic achievement.

Essential differences between revolutionary politicians, who terrorise by use of violence, and bureaucratic ones, who have others exercise terror on their behalf, are that terrorists purchase their arms whilst bureaucrats manufacture them for both sides. Kalashnikovs, poetry in steel, are manufactured world wide. Arms manufacture and occupation of moral high ground are synonymous, profits from the former fund media manipulation to achieve the latter. Terrorist politicians perform their speeches extemporary from the heart, bureaucratic ones read theirs.

Debray was speech writer for Mitterrand during the reformist socialist period of his first presidency. He was sacked during the second, before the decline into mediocrity and total self absorption. His interests are methodology of achievement and maintenance of political power, personality of political leaders, their choice and use of cronies, individual and communal response to them. In addition, what they do for their peers as against their poor oppressed communities and our individual and community reactions to them. Indeed, he thoroughly explores Kant's dictum: Humans are animals that need masters when living amongst other members of the species.

His account of the maelstrom of ideas, motivations, ambitions and ambiguities into which adolescence emerged at the end of the 1950s is brilliantly evocative. Are contemporary adolescents intellectually and emotionally involved in class struggle on behalf of the criminalised oppressed? English language media and media moguls rule their world. Certainly Anglo-Saxon thinking is no longer permeated by concerns from Paris café life as it was then; the francophone volume is down to a whimper. As Debray points out, France is now a canton of Western Europe.

One of Debray's strengths is that he acts like the guide in Dante's Inferno 
He indicates; the reader experiences. Whether intentionally or not, I guess intentionally: Debray dwarfs Mitterrand and inflates Fidel; rather he lets them do so for themselves. Fidel brandishes arms; Mitterrand makes and trades in them. Contrast between truth and enigma. You know where you are with Fidel. Even Mitterrand didn't know where he was with Mitterrand. Although Debray's initial high regard survivesÖbut tattered, not intact.

Debray was in Cuba for revolution. Fidel's primary activity was fermenting revolution. He had training camps for revolutionaries. Dressed in fatigues he trained revolutionaries. He lived in camp, slept on a camp bed set up on a pile of small arms. He had childlike delight and wonderment in the life; belief that a small group of revolutionaries can topple governments. 
Miraculously it had worked in Cuba. Fidel had conviction it could work elsewhere.

The Cuban experience was not exportable, of course. Che wasted his life proving the point. Revolutions occur in a society, lead by home grown leaders, with native passion, bound for glory. They can be trained abroad. They can not be bred abroad. Nor can outsiders substitute for them. Fidel remains Fidel to faithful Cubans; in all societies a minority are unable to kick the habit of hero worship. He became Castro to Debray as a result of the Ochoa show trial in 1989. General Ochoa, the de la Guardia brothers known as los Jimagua, and others were tried for drug trafficking. The U.S. trade embargo, which arguably has kept Castro in power, did not cover this highly lucrative trade, a formidable earner of essential foreign currency. The show trial sacrificed friends of Castro, who had initiated the trade, in the interests of international reputation.

Castro as demagogue, who declaimed five hour long tirades, is media make believe. Rather he ruminated an hour or so, confidentially and enquiringly, on concerns he shared with fellow Cubans, certainly a selected audience. With almost as many Cubans in Florida and thousands in gaol, the available set was somewhat diminished.

Fidel was left with the constituency of poor oppressed he sought to serve. Are their lives richer than downtrodden Americans? Certainly America does little for its own oppressed and seeks to impoverish Cuba, where everyone has access to health care and reasonable quality education. But the comparison Debray presents is with socialist France and its monstre sacré.

The centre piece of Praised be our Lords, a chapter called Disconnection, is reflective, as befits a period of meditation in prison. That it ranges forward as well as back in time is because it was written much later.

However, Che's Bolivian Diary was written at the time. Debray, known as Danton, was used by Fidel as link between Havana and Che's mission in Bolivia. From Che's diary for 1967:
April 2 . . . What has happened to Danton?
April 27 . . The Bolivian radio transmitted army reports which . . confirm Danton is a prisoner near Camiri . .
ANALYSIS OF THE MONTH (APRIL) . . .Danton and Carlos fell victims of their own haste, almost desperation to get out, and of my lack of energy in trying to prevent them, so we have cut our communications with Cuba (Danton) and we have lost our plan of action in Argentinia (Carlos).
ANALYSIS OF THE MONTH (MAY) . . . The fuss about the Debray case has given more combat power to our movement than ten victorious fights.
ANALYSIS OF THE MONTH (JUNE) . . . Debray continues in the news, but more in relation to my case, that now I appear as the leader of this movement.
September 9 . . . suspension of Debray's trial until the 17th . . .
October 3 . . . We heard an interview with Debray, very bravely confronting a student who provoked him.
October 5 . . . The radio reported our two Cambas had been transferred to Camiri to act as witness in the Debray trial. 
The diary ends on October 7. On October 8 Che was wounded, captured and later shot. By then he had gained the opprobrium of Washington, Moscow, Beijing, as well as Caracas and Buenos Aries, probably Havana, quite an achievement.

On November 17 the military court at Camiri condemned Debray to 30 years imprisonment there. He served only four, thanks to de Gaulle and Pope Paul V, improbable petitioners for release of a Marxist revolutionary!

There is no conflict of fact between Debray's account in Praised be our Lords or elsewhere, he's been interviewed on the subject as well as having written about it extensively, including in Che's Bolivian Diary. However, disconnection well describes Debray's interpretation that Che was seeking death. Like all revolutionary activists he risked his life.

Indeed, it would read like a suicide mission if anyone else were involved. But Che had led a charmed and successful life despite chronic illness throughout; he had asthma, with recurrent debilitating attacks. Moreover, his life experiences were not a preparation for failure. He would be justified in regarding himself as invincible. This was the Cuban revolution all over again: Bolivia this year, Argentina next. Debray relays this information too, indeed he was part of the grand plan, but still has Che intent on early death.

Allende did commit suicide. With the presidential palace, democracy, socialism and all he stood for collapsing around him, poetry in steel gave him his preferred exit. Any alternative would have been designed by Pinochet, Nixon or Kissinger, heaven forbid.
By staking his life, the prestigious individual demonstrates that he has been liberated from the first of the servitudes, enslavement to life. He stands as a free man, in contrast to the base individual who refuses to subordinate himself to the Cause (for example, by accepting dangerous missions from the Commander-in-Chief), preferring the petty existence of a toiler who deals with the resistance of things to transform, day by day, the material conditions of existence. In the vassal aspiring to sovereignty, risking death is part of an unconscious strategy of domination, for it is valour in faith and blood that establishes the Master as the Master of serfs. 
 Here it is the revolutionary freebooter putting his life on the line for the Cause. But eventually:
He will no longer listen to the blockade as an excuse, he is bored by the constant redefinitions of the Enemy, he despises national defence as a police expedient. It is one thing to establish an emergency dictatorship to make war, and quite another to make war in perpetuity to legitimise a dictatorship-for-life. To make this distinction from the inside, when you have not been to university to read Hegel and Hyppolite, may well require twenty years of rumination. My own access to the best authors did not enable me to do much better.
He quotes Jean Hyypolite: Mastery - a blind alley - servitude the true path of human liberation.

After ten years in pursuit of revolution in Latin America, Debray returned to Europe in 1975 in expectation of creation of a genuine socialist republic in Europe. He had to wait until 1981 for Mitterrand's investiture. 
Meanwhile, Debray had fallen in love with France all over again and he and Mitterrand had become invaluable to each other.

Although invaluable to Mitterrand, Marxist Debray was an embarrassment to the regime. After the investiture elocution, he was shunted off to an Elysian back room between the cupboard where the hot line to Moscow was housed and the ex-ballroom where presidential papers were accumulated. He thus had access to everything that crossed the presidential desk the previous day. With far less to do he read them and became better informed than his master, to whom he had the access of a familiar. Familiars sit alongside the gilt armchair not the other side the desk like Ministers.

The sequence is depressing. Debray's critiques of Mitterrand tend to be of a generalised type:
An alternation of hopes and disappointments on the left; of anxieties and reassurance on the right. While they live, everything around such people is mitigated, support and opposition both: nothing in their conduct really inspires enthusiasm, or seems seriously deplorable. Their supporters would not risk death for them, and nor would their opponents to bring them down: the two balance out.
We are forced to witness the death throes in France of Marxist Socialists: a proud species that emerged in the nineteenth century from the crossing of the Revolution as myth with the Book as instrument but is now a technical anachronism, doomed to disappear in the global ecology of the videosphere. We had listened to our own yarns, we were living above our means in the imagination: That socialist president had delivered a last generation of socialist dreamers from the century of lies that had done us so much good.

Shortly before he died that socialist president ended his Mémoires Interrompus, written and published 1996: Mais tout cela ne se fait qu'aprés qu'une stratégie de gauche a été dessiné, une dynamique impulse. Il ne faut donc pas changer de cap: le rassemblement à gauche de toute la gauche.

Is Debray's Advice to Younger Generations a spoof or something serious? Perhaps both but to those who want to shine in today's world it is brilliant. He bases it on Mazarin's Breviarum politicorum 1683, which shows little has changed since the days of Loius XIV, or rather that it has changed and changed back again.

He provides a courtier's guide as applicable in the corridors of financial, legal, industrial and commercial as political power. Mazarin's basic precepts were: simulate, dissimulate, trust no one, speak well of everyone, foresee before acting. Read Debray's contemporary advice, apply it, and the cardinal's success can be yours. Or you might prefer to follow Jean Hyypolite's advice.
The final minesweeping review of the history of endless presumption, bottomless hostility and eternal trickery to which we can turn at any age to befoul our maiden souls with an invigorating truth - comes across as masterly and breathtaking.

He concludes with a A Brief Militant's Lexicon as a personal supplement to those that exist already. Political education is discovering that there is no pass-key  - making up your own set of picks as you go along. Here is Debray's soul laid bare, the antidote to Advice to Younger Generations. It deserves careful study.

For me practical politics ended in Augustus 1968, when Soviet tanks rolled into Prague and as in March 1939 and February 1948 western democrats were content to let the Czechs suffer. The last name in Debray's book is Jan Palach's whose suicide at the time he sees as a way of reminding those bogged down in life that reality is not our law and life is less important to free men than their reasons for living it.

Machiavelli chronicled and analysed realpolitik in Renaissance Florence when Savonarola's commonwealth briefly replaced the Medici bankers' military monarchy, backed by the Borgia papacy. Allende's brief intrusion of socialism between military capitalist regimes of Chile, backed by the USA, is a close parallel experienced by Debray. Savonarola and Allende were martyrs to their causes.

Socialism in action in Mitterrand's France, as in northern Europe generally, has as its martyrs the oppressed, raised briefly from their distress only to be impoverished again, awaiting benefits to trickle down through the widening gap between obscene wealth and serfdom.

The President of Cuba, in suit and tie as when he welcomed Pope Jean-Paul II to Havana, was the only world leader to receive a standing ovation from his peers at the fiftieth anniversary session of the United Nations.

How simple everything would be if communism had just been a machine for making prison camps! The curse (or blessing, I am not sure which) is that between the crimes it produced fraternity, self-denial, optimism, courage and generosity.

The Philosopher's verdict: Historically inevitable

Body Dysmorphia (2007)

From The Philosopher, Volume LXXXXV No. 2

The Social and Ethical Challenge
By Simon Woods

We have always celebrated the grace and beauty of the human form. The notion that there is an objective ideal of the perfect human form underpins a classical aesthetic that has become a consistent motif in every artistic genre. The Elgin Marble frieze with its lithe, athletic human figures represents the human form in every possible martial and athletic pose. These classical and idealised forms of human perfection reappear and are epitomised in the Renaissance, in paint, in marble and in the written word. So when Shakespeare's Hamlet says:
What a piece of work is man! How noble in reason! how infinite in faculties! in form and moving, how express and admirable! in action how like an angel! in apprehension, how like a god! the beauty of the world! the paragon of animals! 
We have the words and a repertoire of images to conjure with. However it would be wrong to suggest that classical perfection has been the sole muse for ideas and the arts. Ugliness particularly when coupled with sin and deviance has also had its place. It appears in many of Bosch's paintings, the malign ugliness in Goya's dark paintings and the deliberate "deforming" of the human shape distinctive of the modern and post-modern explorations of the human form.

Medicine also has its place within this history of culture and ideas and has also been influenced, some might say overly influenced, by the classical ideals. The concept of health as a state of perfection as represented in the much criticised World Health Organisation's definition of health is an example of this classical idealism. Concepts of health and disease often play on ideas such as perfection of mind and physical function, and deviations from this state become the basis for defining disease and ill-health. Nor are these efforts to define and categorise disease immune to normative concepts where disease is frequently associated with corruption, deviation, even with sin and immorality. Human moral failings have been closely associated with organic disease even in the contemporary world, so syphilis, T.B, cancer and AIDS have all had morally pejorative associations. It is perhaps in the area of psychiatry and mental illness that these associations are most obvious and most controversial. The anti-psychiatry movement of the 60's and 70's was partly inspired by individuals keen to take the moral and political out of the mental health context.

The taxonomies and terminologies of medicine and psychiatry have done a good job of disguising the moral, political and socially controlling aspects of these disciplines. However the tension that exists between concepts of disease as harmful pathology and the normative notions of disease as moral deviation are still evident in contemporary health care and it is with these thoughts in mind that I now turn to consider the particular challenge of healthy limb amputation.

In the late 1990's Dr Robert Smith a surgeon in the National Health Service performed amputations of ostensibly "healthy" limbs in two individuals who had approached him with this request. His plans to amputate the limbs of a third patient were halted when the Hospital Trust in which Dr Smith was employed prevented him from doing so. How should we regard Smith's actions and the subsequent decision to prevent him from continuing with this work?

The patients who presented to Dr Smith were said to be suffering from a psychiatric illness, a disease "of the mind" that led them to believe that their otherwise healthy limbs did not belong to them and that they would be healthy and whole once the limb was removed.

There are a number of ways in which to begin thinking about this situation. Take for example the phenomenon of the phantom limb, a common experience in those who have suffered a traumatic amputation or elective surgery related to disease. Many amputees often experience this unpleasant symptom, haunted so to speak by the "ghost" of their former limb. One explanation for this phenomenon is the idea that the mental schema of the body is now mismatched, since this schema has failed, or at least partially failed to adjust to the new surgically adjusted physical territory of the body.

One can perhaps draw a parallel to the case of the person who wishes to be rid of a healthy limb because their mental schema is also mismatched with the physical territory of the body. In this instance the physical limb of flesh and blood might be said to be the "phantom" which haunts the person.

So how are we to understand this phenomenon and how ought we to respond as a society in which the health and well-being of our fellows is a shared social concern? Perhaps one way of comprehending this phenomenon is to distinguish the failure to recognise a part of the body as one's own and the desire to have a body part amputated? Therefore a first question to consider is whether there is one kind of case or more.

The neurologist, Oliver Sacks, has described several neurological cases, including his own experience following an accident in which he suffered a serious leg fracture. Sacks describes cases of patients who fail to recognise part of their body as belonging to them - a condition dubbed asomatagnosia. In such cases patients have been known to attempt to throw the alien limb out of bed and have invented all manner of bizarre stories to rationalise how an alien limb has become attached to their body. Cases of asomatagnosia are all associated with a neurological condition, a lesion in the brain or other form of physical damage. But these cases do not exhaust all possible examples of the phenomenon.

Within the taxonomy of disorders recognised by psychiatry there are a number of groups of conditions. These groups share, to a lesser or greater extent, the elements of recognition and desire. The first group is known as the paraphilias in which sexual arousal is derived from non-sexual or inappropriate objects and states. So the infamous examples of shoe, leather and rubber fetishism are examples of paraphilias. The more disturbing phenomenon of paedophilia is also included within this group. Of interest to this discussion are the conditions known as apotemnophilia and acrotemnophilia. The first is a condition in which the individual achieves sexual arousal from the state of being an amputee and includes people who have become amputees and those who strongly desire to become an amputee, the so called "wannabes". The second term is applied to those who achieve sexual arousal from being in close proximity to amputees, known colloquially as "devotees". There is a thriving sub-culture of such individuals within complex virtual and real communities enabling them to indulge in their own particular "paraphilia" or life-style choice.

Again within psychiatric taxonomy there is Body Dysmorphic Disorder (BDD) in which individuals believe that their body is diseased or extremely and offensively ugly causing them to become reclusive and often seeking multiple cosmetic surgeries. There is a view within psychiatry that such disorders are related to conditions such as anorexia nervosa and bulimia sharing in common a "monothematic" delusion, a powerful but false belief that the individual is too fat or diseased or ugly.

The third group is known as Body Integrity Identity Disorder (BIID) sometimes referred to as Amputee Identity Disorder. In psychiatry there is a view that such conditions are related to Gender Identity Disorder in which individuals seek male to female sex-change surgery. It is argued that these cases are similar because the motive is not associated with a sexual desire and therefore not a paraphilia but with the belief that one's physical body is at odds with the mental schema of the body, giving the person a strong sense of alienation from the physical body which is often the cause of severe distress. This distress can be so profound that it often drives people to take extreme measures to seek relief including engineering their own amputations.

All of the conditions discussed here raise issues both for society at large and for medicine in particular. The moral goods with which medicine is concerned, relief of pain and suffering, amelioration and cure of disease, are also strongly endorsed by society. However this does not mean that these goals lack ambiguity. Medicine does raise controversial issues and conflicting intuitions. So how ought we to respond to the apparently "healthy" person who requests the amputation of one or more of their limbs?

One radical and perhaps controversial response would be to argue that this is not a matter for medicine, or indeed for society, but is rather a private matter, a personal choice of lifestyle. On this view, it ought to be a given that people are free to shape and re-shape their physical bodies in the same way that they change fashion or have a new hairstyle. This would require a liberal society in which the "wannabes" and "devotees" are free to pursue their interests within their own sub-culture so long as the costs are met mainly by themselves and not the rest of society. This sort of move would place most of the issues outside of the concern of medicine, except insofar as individuals may wish to buy the services of the cosmetic surgeon to aid in the reshaping of their bodies. This solution, of course, raises quite different questions about repugnance and social norms and the power a society may have to insist upon certain standards of behaviour as a condition of enjoying its membership.

A more troubling case is that of those individuals who are not driven by a sexual impulse or a radical view of lifestyle choice. For some individuals their life is severely impaired by the mere fact that, whilst appearing to be healthy, they are tortured by the existence of an unwanted and, in their view, additional limb. Tim Bayne and Neil Levy, two philosophers interested in this phenomenon, have argued that in the particular case of Body Integrity Identity Disorder (BIID) the medical model, involving surgical amputation, is appropriate and justified. They argue that the suffering of the person is real and significant enough, with a high risk of associated self-harming. The belief is rational enough and there is no other therapeutic alternative since the condition has proven resistant to psychiatric treatments. Bayne and Levy also argue that the outcome of the intervention is good in the small number of cases where amputation has taken place either surgically or through self-harm. Following such interventions the individuals do not request subsequent amputations and appear content with their reformed bodies. However, as convincing as these cases may seem, there are some complications that must be addressed. For example, in order to show that the outcomes of amputation are indeed good there is a need to conduct research on a sufficient number of interventions that are rigorously assessed and followed up.

There is, of course, the methodological problem of designing such a study. For example to what form of intervention would this be compared? There is also the further problem of whether such a research project could be sanctioned by a research ethics committee. However, a failure to make this enquiry or to provide these clinical services means that people will go on suffering; they may take drastic self-harming action forcing medicine to respond and pick up the pieces, or they may die in the process. All of which are serious harms worthy of medicine's and society's concern.

This essay has raised a number of intriguing questions in the context of healthy limb amputation that span several fields from philosophical questions about the nature of mind and the mind/body interface, questions in the philosophy of medicine about the nature of disease and impairment, social and political questions about the freedom to pursue life-style choices and the hard practical questions of medical ethics. There is not an easy solution to any of the questions raised here, but the issues are sufficiently complex to demand further enquiry - the main aim of this essay is to contribute to that enquiry.