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By Carla Power
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Philosophers, physicians and religious scholars have pondered the question for centuries: is it right to kill one person to save the life of another? In Britain last month the theoretical debate became painfully real after conjoined twins were born in Manchester. The twins, known as Mary and Jodie, were born joined at the abdomen, sharing a spine and an aorta. Mary, the weaker of the two, relies on Jodie for oxygen and blood circulation. Doctors say that if nothing is done, Jodie's circulatory system will become overburdened and both twins will die. But if they are separated, at least Jodie will have a chance for survival. Last week the Court of Appeal in London concurred and ordered that the twins be surgically separated. "[Mary] sucks the lifeblood of Jodie, and her parasitic living will soon be the cause of Jodie ceasing to live," wrote Lord Justice Alan Ward in the decision.
The ruling went directly against the wishes of the twins' parents. Known only as devout Roman Catholics from the small Mediterranean island of Gozo, they have said all along that they do not want medical intervention. "This is not God's will," they wrote the court. "Everybody has the right of life, so why should we kill one of our daughters to enable the other one to survive?" Backed by powerful members of the Catholic clergy, they will almost certainly appeal the decision to Britain's House of Lords.
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Things weren't supposed to happen this way. When the couple first learned that they were expecting conjoined twins, they deliberately went to Manchester to give their newborns the best chance of survival. But when the parents refused to consent to the operation to separate the girls, doctors at St. Mary's Hospital referred the matter to the courts. A High Court ruled that the twins should be separated; the parents appealed. A Catholic hospice in Ravenna offered to care for the twins free of charge, and the leader of England's Roman Catholics, the Archbishop of Westminster, pleaded with the judges to allow the parents to take the twins there. The judges refused, and last week issued a 130-page verdict, in which they unanimously ruled that the operation was legal.
The ruling has sparked furious debate. While many have praised the decision as a pragmatic solution to a tragic situation, others question whether the courts should be involved in the first place. "The decision should be left to the parents in these types of cases, unless the parents are negligent or very weird--which doesn't appear to be the case here," says Raanan Gillon, editor of the Journal of Medical Ethics. "There is no reason for doctors or judges to override their views." Others fear that the ruling could set a precedent for favoring the strong over the weak or infirm in medical decisions. At the Ravenna hospice that offered to take in the twins, the staff is indignant. "We would have cared for them, that we do know," says Father Matteo Solaroli, director of the Hospice of Santa Teresa. "Beyond that, we do not know. No one knows how long the girls would have lived, or what other marvels might be invented in the meantime." For now, Jodie and Mary lie in an incubator in Manchester, oblivious to the storms raging around them.
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