Passions Run High On Fate Of Endangered Siamese Twins
Sydney Morning Herald
Saturday September 9, 2000
The case of ``Jodie" and ``Mary" has assumed biblical proportions, not least for Britain's judiciary, but even the wisdom of Solomon would seem incapable of resolving the ethical quandary.
Worldwide, the plight of the Siamese twins who cling to life in an incubator in a Manchester hospital is fuelling fierce debate.
University examiners could hardly compose a tougher test for budding ethicists whether to separate the twins and cause the certain death of the weaker child, or let nature run its course, in which case both children will almost certainly die.
On radio talkback and in online chat rooms votes are being cast, even from Australia.
``Surely the doctors do not think that they have the right to decide on behalf of the parents which child should die?" wrote one Australian this week in an email to the BBC. ``Let the parents have the final say."
From the Netherlands: ``If the twins were my children, I would never separate them. They were born together and should be left alone to have the dignity to die together."
But non-intervention is not necessarily the majority view.
Others argue just as vehemently that saving a life is paramount.
``It's an unpleasant thing to know that you're going to end the life of a child in favour of another," said a Londoner. ``But it's perverse to choose to let them both die rather than have the courage to make that decision."
Next week, three Law Lords sitting in Britain's Court of Appeal will decide whether the twins, born almost five weeks ago, joined at the abdomen, will be surgically separated.
Legal observers expect them to sanction an earlier High Court ruling and choose what many describe as the lesser of two evils separation, at the cost of the life of the weaker child, Mary.
But their ruling may not end the matter. The parents, devout Catholics from a remote part of eastern Europe, have indicated they will take the case to the European Court of Human Rights if their appeal fails. They say they simply cannot sanction the ``killing" of one of their daughters.
``We cannot begin to accept or contemplate that one of our children should die to enable the other one to survive. That is not God's will," they have told the court.
So far, battle lines have tended to be drawn between the medical profession, which advocates separation, and those who like to refer to the sanctity of human life. Universally, however, the combatants agree that the decision is an agonising one.
The Catholic Archbishop of Westminster, the Most Rev Cormac Murphy O'Connor, encapsulated the problem: the moral principle that it was wrong to do evil, even if it resulted in good, had to be balanced against the need to save a life, he said.
The couple, whose identity has been suppressed, came to Britain to seek expert medical attention when it emerged that their daughters were conjoined a one in 50,000 occurrence.
That they sought such assistance, some observers claim, undermines the weight of their argument. If they wanted the best medical care then, why not the best medical advice now?
The Law Lords this week ordered a second medical opinion from a specialist team from London's Great Ormond Street Hospital for children, which has separated 17 sets of twins. An experienced surgeon and a pediatric cardiologist concluded that the original diagnosis by doctors at St Mary's Hospital was fair.
Manchester's health authority had gone to the High Court to obtain legal sanction for the separation after concluding that the twins would survive only a few months without surgery.
The weaker child, Mary, was born without a heart or lungs and with an underdeveloped brain, and relies on Jodie for oxygenated blood. But the strain on Jodie's heart was telling, they argued.
In the appeal court this week, further evidence was offered about the twins' first hours of life, on August 8.
Of Jodie, doctors wrote: ``Baby crying and active. Good HR [heart rate] and respiratory effort. Moving all four limbs." But Mary, they said, required a face mask and oxygen. ``Very stiff to ventilate. No chest movement or breath sounds."
Lord Justice Ward, who told the court that the case was causing him sleepless nights, played devil's advocate, arguing that barristers for the doctors needed to persuade the court that it could exercise parental jurisdiction and say: ``Save Jodie but murder Mary."
``I put it starkly, but that may be what you are inviting the court to do," he said.
© 2000 Sydney Morning Herald
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