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Lord Justice Alan Ward
"The most dramatic questions of life and death involved"
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The BBC's James Westhead
"A deeply troubling and tragic case"
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Friday, 22 September, 2000, 11:21 GMT 12:21 UK
Agony of Siamese twins judge
jodie and mary
Jodie and Mary are now six weeks old
One of the judges who will rule whether the Siamese twins should be separated has spoken of his agonising decision.

If the operation - which is strongly opposed by the parents - goes ahead, Mary, the weakest twin, will definitely die.

However, if the two were to remain joined, then experts say they would both certainly die - possibly within months.

Lord Justice Alan Ward, speaking to the BBC as he arrived at the appeal court to deliver the verdict, said: "It has been excruciatingly difficult. One's heart bleeds for the family.

"50% of the population will agree with the decision - 50% will think we have gone potty."

The twins were born at St Mary's Hospital in Manchester six weeks 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.

Jodie has a developed heart, lungs and liver - Mary does not, and is said by doctors to only have a "primitive" brain.

The High Court has already ruled that the operation should go ahead, but the Official Solicitor, who represents the children, appealed on behalf of the parents.

Should the appeal judges agree with the first decision, then the parents are likely to take their appeal to the House of Lords.

But a final decision is required fairly swiftly. Surgeons would like to operate when the twins are three months old to maximise the chances of saving Jodie.

Because Mary has no lungs or heart, Jodie's organs must bear the extra strain of supporting both, and doctors believe that this situation cannot be borne indefinitely.

Cormac Murphy O'Connor
Cormac Murphy O'Connor: Opposes the operation
They think that there is a reasonable chance that Jodie would survive the operation, although she could be left disabled.

Dr Harry Applebaum, a US surgeon who has carried out Siamese separation operations, told the BBC: "I think in this situation we do have a person who can function normally following an operation."

The prospect of knowingly setting out on an operation that will kill one baby has provoked strong opposition from pro-life groups.

And the Catholic Archbishop of Westminster, Most Rev Cormac Murphy-O'Connor, submitted evidence to the court urging for the operation to be refused.

Professor Raanon Gillon, editor of the Journal of Medical Ethics, told the BBC: "It's far better to let the parents decide.

"I have to say that if I were making the decision myself and if I were convinced that one child would be saved then I personally would chose the operation.

"But I don't think my view or anybody else's view should be imposed on parents who conscientiously choose the opposite."

The three judges have contacted judges in Australia, South Africa and Canada to see if there were any similar cases to give guidance. But there was none.

One of them, 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.

However, experts believe the case could still go to the House of Lords for a final decision.

Allan Levy QC said either of the losing parties could apply to have the case heard by the law lords.

"One of the losing parties could ask for permission to appeal to the House of Lords and I would have thought it would almost certainly be granted."

He added: "I would have thought that if the doctors lose, unlike the parents, they would want the five judges of the House of Lords to decide the matter."

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06 Sep 00 | Health
Experts back twins' separation
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