Siamese twins to be separated

Jodie and Mary are now six weeks old

Siamese twins Jodie and Mary should have an operation to separate them, even though one will certainly die, the Court of Appeal has ruled.

But the parents are now allowed to go to the House of Lords with a final appeal against the operation.

The scales come down heavily in Jodie's favour

Lord Justice Alan Ward

The operation would effectively condemn Mary, the weakest twin, to death.

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

The decision of the panel of three judges was unanimous, and one member, Lord Justice Alan Ward said that Mary had been living "on borrowed time".

The family come from the island of Gozo

"The scales come down heavily in Jodie's favour," he said.

"(Mary) sucks the life blood of Jodie and her passive living will soon be the cause of Jodie ceasing to live."

The parents, devout Catholics from the Mediterranean island of Gozo, near Malta, believe it is "God's will" that both should die.

The family's solicitor John Kitchingman, said the parents would consider their next step.

"The next step is to take stock of the judgement to look at what has been said by the judges, to give legal advice to the parents.

"Only when they have heard our advice, I think, will they be able to make a decision as to what they intend to do."

A statement from the Central Manchester Healthcare NHS Trust said its doctors would not proceed with the operation.

"We will continue to liaise closely with the parents of the twins and their lawyer and no action will be taken without their knowledge."

The cost of the twins' treatment is being funded by the NHS in a reciprocal agreement between the British and Maltese governments.

Earlier, Lord Justice Ward spoke exclusively to the BBC about the agonising nature of the decision.

He 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."

Reacting to the ruling, legal expert Allan Levy QC said: "In the main it's a decision for the preservation of life - the twin with the reasonable prospect of life will be saved."

He said he did not feel that it offered "a green light for euthanasia".

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

'Primitive brain'

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.

A final decision is required relatively 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: 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.

Archbishop opposed

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

And 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 were none.