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BBC Health Correspondent Richard Hannaford
"The case has already caused sleepness nights"
 real 28k

Wednesday, 13 September, 2000, 16:41 GMT 17:41 UK
Weaker Siamese twin 'draining sister'
Judges will decide whether the operation goes ahead
A Siamese twin who is doomed to die is growing at the expense of her sister who doctors believe they can save, the Court of Appeal has heard.

The revelation came during the fourth day of a highly emotional hearing into the future of the twins, known as Jodie and Mary.

Doctors want to operate to separate the twins, but surgery is opposed by the girls' parents.

It may be that Mary is drawing nutrition from Jodie and growing at her expense

Adrian Whitfield QC

The twins were born at St Mary's Hospital in Manchester one month ago.

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.

If an operation to separate them goes ahead, Mary, the weaker of the two, will certainly die, while Jodie has a chance of survival.

However if the operation does not go ahead experts say both are likely to die within three to six months.

Their parents, from a Catholic community in a Mediterranean country, strongly oppose the operation on moral grounds, saying it is "God's will" that both should die.

Doctors and the Central Manchester Healthcare Trust have taken court action to allow the operation to go ahead.

The High Court ruled that the operation should go ahead, but the official solicitor has appealed on behalf of the weaker twin.

Medical update

On Wednesday, a QC for the doctors gave an update on the medical condition of the twins.

Mr Adrian Whitfield QC, appearing for Central Manchester Healthcare Trust and the doctors, said Jodie was not growing as the surgeon treating her would expect, while her sister was "growing normally".

He told Lord Justice Ward, sitting with Lord Justice Brooke and Lord Justice Robert Walker that the latest assessment showed Jodie's heart remained steady and there was no sign of failure.

But the surgeon had noticed Jodie's lack of growth in the past week, as had a nurse.

Mr Whitfield said: "From the physical point of view, Jodie is not growing, although she is eating well.

"The surgeon thinks it may be that Mary is drawing nutrition from Jodie and growing at her expense.

"This could have implications for the timing of the operation (if separation is sanctioned by the courts), but there is no immediate rush."

Mr Whitfield said the surgeon would continue to monitor the twins' progress over the next week or so.

He said that unless Jodie continued to grow in a normal way the best time for surgery to take place would be when the twins reached the age of three months.

A continued failure to thrive would advance that date by about four weeks.

Earlier Lord Justice Ward said judges in Australia, South Africa and Canada had been contacted to see if there were any similar cases to give guidance. But there was none.

Catholic appeal

The court gave the Pro-Life Group and the Roman Catholic Archbishop of Westminster, the Most Rev Cormac Murphy-O'Connor, permission to make written submissions on the case.

The Archbishop has said it would be "unacceptable" to override the wishes of the parents and the twins in "the tragic and heart-rending" case should be allowed to die.

Nicola Davies QC, for the Attorney-General, who is not a party to the action but is assisting the court, said that the parents in the case would not be criminally culpable in not consenting to the operation, even though that would lead to Jodie's death.

Lord Justice Ward said that the parents were "on the horns of an irreconcilable dilemma", which was one of the "ghastly" features of the case.

The appeal continues.

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See also:

25 Aug 00 | Health
Siamese twins 'must be separated'
06 Sep 00 | Health
Experts back twins' separation
12 Sep 00 | Health
Jodie and Mary: The medical facts
11 Sep 00 | UK
Judging a moral minefield
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