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Is it right for doctors to perform such a procedure only after all other known therapeutic methods on a patient with BIID?

Is it fair that there should be regulations on surgeries, or should doctors be allowed to diagnosis and perform on a patient on a case-by-case basis?

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LET ME SEE YOUR WAR FACE!!!

If the patient wanted her legs gone and had the means to pay for surgery, she had every right to proceed as she wished. It isn't the government's place to decide what medical treatments a person "should" or "shouldn't" undergo (except abortion, which involves another person). As much as I personally feel sorry for her and would have encouraged her to try other options, I would not have regulated her decision on a governmental level. The slippery slope of declaring such people "mentally ill", ostensibly "for their own good" is one that totalitarian states, most notably those of Hitler and Stalin, have used to their advantage.

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"Some people complain about the system. The system is not good, so they can't do anything. It's an excuse. Freedom is in your heart." (Jin Xing)

I do believe this people are mentally ill (just as I believe transgenders are mentally ill), but that doesn't that the best treatment for their illness be doing what they ask for, especially if they make it very clear that they will perform a very risky procedure on themselves if no doctors will amputate. I wouldn't support such a procedure until every other treatment has failed.

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LET ME SEE YOUR WAR FACE!!!

I have no doubt that the woman mentioned above is mentally ill in some sense, but at the same time she was not a danger to others and, since she would have preferred surgery in a controlled setting, was not truly a danger to herself, ironically, without the government regulations. As for transgendered people, I don't think they are mentally ill. The brain is the person, and transgendered women, for example, have female brains and male bodies. I regard SRS as corrective surgery. The difference between a transgendered person and someone with BIID is that, while being crippled, for example, is an abnormal, unhealthy state, being male or being female is a normal, healthy one. I'm referring to fully transgendered people, by the way, not to "pre-op" people who can't decide on their gender. I would regard them as having a psychological problem rather than or in addition to a physical one.

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"Some people complain about the system. The system is not good, so they can't do anything. It's an excuse. Freedom is in your heart." (Jin Xing)