I first posted this on September, 2000.
As reported by CNN.com, September 22, 2000 1358 GMT, The UK Court of Appeal has ruled that an operation to separate conjoined twins is to be allowed to go ahead. At issue is whether doctors should be allowed to separate the six-week-old girls in an operation which will kill one child to allow her sister to live. The twins were born at St. Mary's Hospital, in Manchester, north England, on August 8.
The conjoined twins, identified only as Mary and Jodie, are joined at the abdomen and share just one heart and one pair of lungs. They are joined at their lower abdomens, with their heads at the opposite ends of their merged bodies and their legs emerging at right angles from each side.
Dr. Richard Nicholson, editor of the Bulletin of Medical Ethics, has said that if the separation of the twins goes ahead, the quality of Jodie's life could be severely affected. "Her prospect of any high quality of life will be very small," he said.
Lord Justice Alan Ward, one of the three appeal court judges involved in the decision, said: "It has been excruciatingly difficult. ...One's heart bleeds for the family... Do we save Jodie by murdering Mary?...Say yes and you murder Mary, say no and you murder Jodie. This is the most awful dilemma to contemplate.
Doctors say both girls will die within months if they are not separated. An operation to separate them would kill the weaker twin Mary, who depends entirely on Jodie for her blood.
Their parents, who traveled from their home in the eastern Mediterranean to Britain for the birth, are devout Catholics and have said God, not doctors, should decide whether the twins live or die. "We believe that nature should take its course. If it's God's will that both our children should not survive then so be it."
There's more. You can read it at http://www.cnn.com/2000/WORLD/europe/09/22/britain.twins.02/index.html. As usual, CNN invited viewers to write in with their opinions, and, as usual, Americans and others once again demonstrated that there are an awful lot of confused people out there.
Part of the confusion has to do with the fact that the parents are Catholics and that their remarks, no doubt made under great distress, reflect only imprecisely what the teaching of the Catholic Church and, by implication, their belief, is on this issue.
Actually, there are two teachings involved. They can be summed up as follows:
Principle #1. Everybody has an obligation to act to bring about the common good.There are some other simple principles involved, i.e:
Principle #3. Nobody can foretell the future.Finally, there is the question of British law, which, as I understand the comments of contributor Tony Brogan, is:
Principle #6. Physicians in the United Kingdom have a legal obligation to act in the best interests of their patients.The CNN contributors seem confused about these principles and, in some cases, appear to find them mutually contradictory. The issue is further clouded by the weight given by the general public to statements made by people referred to as "doctors" and a general suspicion of "Catholic Teaching." As a Catholic, I would like to make my attempt to clear the air.
Now, I want to make it clear that I am not blaming anyone, or imputing impure motives. I believe that Lord Justice Ward and the doctors involved are truly agonizing over their duties and responsibilities in this matter. I would be very surprised if any of them are consciously acting on the basis of anything but the highest of moral principles.
The problem is that they seem to be as confused as anyone else, and I believe that this is due to their being themselves victims of our culture, which has put principle #5 ahead of Principle #2 for a very long time. And make no mistake about it, friends and neighbors, principle #5 is very definitely a factor!
Principle #1 requires parents to act in the best interests of their children, the courts to act in the best interests of social justice, physicians to act in the best interests of their patients, et cetera. British law appears to comply with this by observing Principle #6. However, because of principle #3, nobody can know precisely what the best interest or common good is, so they have to make their best guess. In this case, that's difficult to do, as Lord Justice Ward pointed out, but principle #1 requires all concerned to do it, nonetheless.
Principle #4 gives some guidelines. On the one hand, (the good of) preserving or extending the life of Jodie, multiplied by the probability of doing that, has to be balanced against the good of spending all that time and resources on preserving the lives of other people, multiplied by the probability of doing that. This is a very real concern in the United Kingdom where, because they have socialized medicine, there is a "God squad" which decides in such cases where the resources should be best used. Apparently they haven't gotten into the action yet.
Principle #4 also applies to the amount of money to be made (principle #5) by doctors, lawyers, hospitals, medical supply houses, journalists, photographers, souvenir hawkers and other assorted buttinskis if the twins are separated in an internationally televised operation, multiplied by the probability of all these people making all that money, which is a virtual certainty. The product of money to be made multiplied by the probability of making it actually can be specified in pounds or eurodollars, and ranges in the millions. Principle #4 also applies to the amount of money to be made if these unfortunate little girls do NOT have an operation, which is zilch!
All that money!
Finally, principle #4 applies to the girls themselves. On the one hand, we have the good that Jodie will live (longer) if she is separated from Mary, multiplied by that probability, versus the good that Mary will live (at all), multiplied by that probability, which, of course, is absolutely zero! Zero times anything is still zero!
In other words, Jodie and Mary might live for a while if they don't have that operation, whereas Jodie might live a little longer but Mary will certainly be killed if they do. How long Jodie might live, or what her quality of life might be during that time, is the subject of principle #3. According to Dr. Nicholson, the outlook is not good. How long Mary might live is determined by the length of time during the operation that it takes to kill her. That's just plain old morally wrong! Basically, what we have here is the difference between intentionally killing someone to achieve a good purpose Principle #2 and untentionally killing someone while trying to save someone else's life. Principle #1
The people who stand to make the most money from this are carefully avoiding the fact that these little girls have already lived six weeks, and are likely to live for some time yet if they are just fed, loved and cuddled. There are conjoined twins over forty living today! If you want information about the life of conjoined twins, ask Abby and Brittany Hensel! They are also carefully avoiding making any predictions about how much longer Jodie will be likely to live than she would otherwise if they kill Mary. It is not a question of keeping Jodie from dying, because both babies are certainly going to die, as are we all. The question under consideration is how much longer Jodie will live if Mary is killed than she would if Mary was allowed to live the same amount of time.
Of course, principle #3 applies here, but I think the motivation is really principle #5. If someone who is likely to be listened to points out the truly enormous investment involved, and the minuscule improvement in Jodie's length or qualify of life which is likely to result, reasonably sane people might begin to question why anyone in his right mind would suggest spending so much for so little return. So much for principle #5.
In other words, Lord Justice Ward is wrong. Nobody is going to save Jodie by murdering Mary. The best that they can hope for is to allow Jodie to live somewhat longer by murdering Mary, for how much longer nobody really knows. Principle #3 again. But it really doesn't matter. Principle #2 still governs.
Nobody except Lord Justice Ward has even suggested murdering Jodie. The concern is that Jodie might not live as long if they do NOT murder Mary. Taking the chance that someone might not live as long if you do not murder her sister is not the same as deliberate, premeditated murder of that someone. Somebody who calls himself a Justice, especially a Lord Justice, really ought to know the difference!
I might point out at this point that CNN reported that British newspapers had said that The Catholic Archbishop of Westminster, Cormac Murphy-O'Connor, would ask for the twins to be allowed to die. I kind of doubt that! What I think the archbishop probably said was that if the only choice is killing Mary or letting both of the twins die, then the only acceptable moral alternative is the latter. Principle #2 again. Somebody doesn't get to be an archbishop in the Catholic Church by going around saying silly things like, "Well, I don't think anyone should do anything to keep them alive; I would ask for the twins to be allowed to die." Note that I did NOT say anything about anti-Catholic bias in the British press or CNN.
If you want to bring God (Fate, whatever) into the picture, "God" created this situation and dropped it into the laps of those concerned, for what purpose we mortals do not know. But "His" guidelines are very clear on the subject. "Love one another," (John 13:24) and "Thou shalt not kill." (Exodus 20:13) (principle #2) Which of these do the Lord Justices not understand?
Loving these babies means taking care of BOTH of them and trying to make BOTH their lives as long and as comfortable as possible. It does NOT mean killing one of them so the other can live longer! It does NOT involve asking the doctors to arrange things so that neither of them never dies, which is impossible.
Back in Germany in the 1930's, laws were passed that purportedly protected physicians from criminal prosecution if they chose not to try to save people suffering from fatal birth defects. The idea here was that depression-era Germany's limited medical resources could be better used truly to help sick and injured people who had a reasonable expectation of benefiting from that help. Not too many years later, they were shoveling Jews and Gypsies into the crematorium ovens because they were "defective." So much for principle #1.
The last half century has seen a rejection of principle #2 around the world, and particularly in this Country. There are over 30,000,000 potential U.S. citizens who will not be paying into Social Security because somebody killed them before they could claim citizen rights. There are a lot of excuses for this. Most of them use the word "just." Just fetuses. Just niggers. Just handicapped people Just old people. Just Jews. But the real reason is principle #5. Raising children costs money. Educating people who have been victimized by centuries of social injustice costs money. Taking care of old and handicapped people costs money. At least the Nazis were honest enough to admit that the real reason they were cremating the Jews was that they "cost money."
Principle #1 requires the parents, doctors, lawyers, judges, and everybody else who can do something positive for these little girls to do that. Feed them. Love them. Cuddle them. PROTECT them! There's even money to be made doing that.
Of course, there is much MORE money to be made by the nationally televised operation!
All that money!
So, given the relative emphasis on principles #2 and #5 in the allegedly "civilized world," I am going to violate principle #3 and try to foretell the future. I sure hope I'm wrong!
I believe that, in the not too distant future, a team of rich lawyers will convince a court of rich judges to take these babies away from their parents and give them to a team of rich doctors to perform an operation from which a lot of people connected with the hospital are going to get rich. Sometime during that operation, one of the surgeons will clamp off her major arteries and kill Mary.
Of course, they won't admit that. They won't mention the money at all. They will probably not realize that it is even a factor. They'll claim, and probably truly believe, that they were working with the highest of ethical motives, (Principle #6), to try to "save Jodie's life."
Then, someday, somehow, Jodie will eventually die, and that will be the end of that!
All that money!
They claimed that Jodie's "chances of survival are now much stronger," and quoted one of the doctors involved as saying, "It could range from a very good quality of survival, where she can walk and function normally, to the other extreme of not being able to walk and being incontinent."
As I predicted, some time during the 20-hour operation, the attending surgeons killed Jodie's sister Mary.
On April 23, 2001 it was reported that Jodie had made steady progress since the operation, and could be well enough to go home in a fortnight. According to a report on December 7, 2000, Jodie will face years of corrective surgery and skin grafts but doctors say if she survives she could have normal intelligence, be able to walk, have an average life expectancy and even have children. It will be interesting to see how well Jodie does. I hope she has a long and happy life. Her sister died to provide it for her.
As 0f 2014, Jodie was a normal, happy, healthy teenager, going to school and hoping to become a pediatrician someday to "help people." I salute Judge Sir Alan Ward who had to make the terrible decision that gave her the life she is living now. I am thankful that I wasn't the one making it, and I am happy for Jodie and her family, and for the wonderful outcome of Sir Alan's decision.
You can read some other discussions here, and the latest information at this update here and here.