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Friday, 22 September, 2000, 17:02 GMT 18:02 UK
Siamese twins: Who should have the final say?
The UK Court of Appeal has ruled that the Siamese twins, Jodie and Mary, should be separated.
The operation will kill Mary because she relies on her sister's vital organs.
In a unanimous ruling, the judges said the case had been an agonising one, but in the end, the healthier twin had a chance of survival, whereas Mary was beyond help
Read what you had to say ahead of the ruling by the Court of Appeal.
This debate is now closed.
If the choice is as simple as it looks: inaction will result in two people dying whereas action will result in only one dying, couldn't you argue that inaction would be murder?
I couldn't live with the fact that I had to tell my daughter that she had a sister and they had to be separated to keep her alive. I think the parents should make the decision because it's their child.
I think the parents have the decision to choose what happens to their children not the doctors.
Even though the court would go against the parents' wishes to separate the children, surely it is better to have at least one child, rather than no children.
Ade Bakare, London
I think that the parents are faced with a very difficult decision. I have been brought up as a Roman Catholic, but in this case, as many others, I would have to disagree with the church. The fact that the other child may become disabled is no excuse for not going ahead with the operation. Actions which may lead to the preservation of life are almost always correct. This is one time when science is correct, and religion is wrong.
How can people be so mean to
question the price of the
operation to the NHS?
Dave Adams, USA
One of the babies isn't a viable entity.
That's a fact. She's going to die. To have
a lawyer speaking for her is an absurdity,
just as it is for the parents to think that
to let them both die is better than saving one
at the expense of the other.
Due to the complexity of this situation how can any choice be the right one? The decision should be left to the parents as they are ultimately the ones who will be left to cope with outcome of this tragedy.
Who is paying for the medical treatment of the twins? Is it fair on UK residents who have to wait for operations on the NHS?
I do not agree that these twins should be separated. Who are we to know for sure what the future holds for us? No doctor, scientist or judge knows and the parents should have the final say in the matter.
Martyn Tueton, England
If God wants the final say, then maybe God should show up and do the operation.
I cannot believe that anyone has the right to decide the best course of action here other than the parents. Where will the judge and doctors be when those parents have to live with their decision day after day?
The parents brought their children to this country to seek the advice of experts. Having rejected this advice, they should take their children back to the land of their forefathers to live out the rest of their days in their own culture.
This unfortunate story is one example of how damaging religion is to the world.
As a Roman Catholic myself, I believe that nobody has the right to take the life of another. I believe that the two girls will be better off in Heaven together than for one to survive through the killing of the other.
We do not respect the wishes of parents who beat or abuse their children - why would we then respect the wishes of parents who would prefer both their children to die than have one live? It's clearly an extremely emotional and painful time for the parents, but at the end of the day if the choice is for one of the children to die, or both of them then that's no choice at all.
Of course the parents should have the final say, the twins are after all, THEIR children. The courts know very little about them. Ask yourself one question, would you let complete strangers decide your children's future?
Jayne, UK (from the Netherlands)
If God's will is law to the parents why did they seek medical intervention?
Why did they choose to come to the UK? Are they making a contribution to the cost of NHS treatment AND who is footing the legal bill? The UK gets sucked in again. Why? How?
Is it right to murder one child to save the other?
I had always thought that the law was an ass, this proves it.
We all have an opinion now, but what must it be like to actually have to make the decision for real? Would we all be able to keep our stance, on whatever side of the fence we stand at the moment?
The healthy twin will start to become malnourished and ill, and the weaker twin runs the risk of becoming even more brain damaged than it is at the moment. Unable to see or make a noise of pleasure or pain what kind of torment will it go through when the stronger twin starts to move about more, whilst the parents wait for them both to die?
It's an unpleasant thing to know that you're going to end the life of a child in favour of another. Buts it's perverse to choose to let them both die rather than have the courage to make that decision.
The Convention on Humans Rights, which is
part of English law, say that everyone has
the right to life. The proposed operation
completely ignores the weaker twin's right
to life. Of course, you could argue that the
stronger twin's right to life means that she
should be entitled to the medical care she
needs in order to live, but in this case the
necessary operation requires that another
human life be terminated.
If the Catholic Church had had its way in the first place, the medical research that enabled these children to be born at all would probably never have been carried out. It is unreasonable for the Church to consider itself entitled to "cherrypick" which moral issues it wants to confront and which it wishes to duck. The medical professionals have started a job, and should be allowed to finish it, without moral "advice" from an organisation that is singularly unqualified to offer it in the circumstances.
I'm sure that the parents of Jodie and Mary understand this. I believe that they must be horrified to come to our country expecting help and mercy only to find their rights and beliefs trampled on in this manner. (I feel ashamed to be British at times like this.)
H Dickins, UK
The argument here seems to evolve around religion, and whether it is God's wish for both or just one child to die, and why should Modern medicine be use to make that decision.
Well if there is a God why did he empower us mortals with the knowledge to be able to carry out such an operation to save a life, surely the biggest test of all.
Why is there so much focus on the fact the parents are using their religion to justify their decision?
I am an atheist myself, but I think I too would be quite unable to decide to give up one child for another. So why is everyone so outraged?
Tony White, UK
Surely in this day and age people can not justify allowing children to die as "God's will". If the parents feel they will not be able to adequately care for the one child, authorities should act as to ensure the child leads a 'normal' life as possible. There should be no hesitation.
I don't think these parents have made their decision easily. It seems to me there are no certainties in this. Both children may still die. I'm a father of two children, If I had to decide which one should die so that the other should live, I couldn't do it. How can a doctor make this decision? Also how will the one who survives live with this as they grow up. I'm not sure we really comprehend the complexities of this situation. It's very easy to talk about it when we are not emotionally involved.
Isn't there more to this than is being reported? I understood that the parents would have a problem caring for a disabled child in their remote community and would have to leave the surviving child behind to be fostered or adopted?
If god is so important to them, why did they travel here for medical assistance with the birth? It seems a perverse morality to engineer a safer birth only to allow both children to then die when one could possibly be saved.
When will people come out of the dark ages and start to believe doctors rather than the out dated bible? They will be very selfish parents if they allow a child that could be saved to die, just because of some writings in a book.
If it is possible to have one child survive then surely that must be better than certain death for both. However, in the parents position (and as a parent myself), I can't imagine I would be able to take that decision, knowing that one of the children would die. I think therefore it must be better for the decision to be taken externally and rationally.
It is commendable that the parents trust in God, however, in this instance it is physically known that one of the twins has no heart and no lungs. This means God or no God that they will both die as hearts and lungs are not powerful enough to sustain both lives. Hence, the parents ought to try and save at least one of the children and let the other twin peacefully die.
If the parents cannot make this logical decision, the law has to help them otherwise the parents may have unlawfully let the viable child perish. There is only one stage in embryonic life where a mother (parent) can decide on life or death and that is during abortion. After that phase it is unlawful to obstruct viable life of one of the children. Hopefully they agree before the are forced to.
Surely the doctors do not think that they have the right to decide on behalf of the parents which child should die. Let the parents have the final say.
Courts should always be allowed to intervene if it is in the best interests of the child. This case, though, poses an absolutely dreadful dilemma for both the parents and society in general. Of course everyone wants both children to live, but to condemn one to die in order to save the other risks being accused of state-sanctioned murder. I would hate to be a parent in this situation or the judge making the decision. We can play God with simple things, but this is a problem requiring divine intervention rather than the judicial variety.
I think the ultimate decision should be the parents for they are the ones who will have to live with the decision that they make. I think no one should have the right to enforce a decision upon them. This is how our society ruins other people's lives. Motto: Live and let live. Help if help is asked for and you are in a situation to be able to offer it but do not force it upon someone. Freedom of choice.
I think the parents are right to say that they do not want the twins to be separated. Anyone who is a parent would NOT want to have to make a very difficult and a heart breaking decision on which one of their children should die. To ask them to make a choice of such nature would be impossible where any human life is concerned regardless of religion. I could understand the courts wanting to intervene if there was a chance of both twins surviving, but as this is not the case the final decision should be left with the parents.
Will the court also force the parents to love the child that survives?
On the face of it, this looks like the medical and legal experts saving a life. I like most other parents feel strongly that the parents of these twins should be allowed to choose to keep both if they wish. It is they who will live through the consequences, and their faith in God should be honoured, even if we can't all understand how their faith could move them to their conclusion. Certainly our legal system shouldn't force them down a road they clearly don't want.
Has anyone thought of the outcome if the twins don't undergo surgery. One would assume that the weakest of the twins, who does not have life supporting organs, will give up first. That will leave the surviving twin still attached to the dead twin. How can anyone imagine what terrors that will hold, for one, even so young.
My response is quite simple! If they wanted to leave it to God or to nature then they ought to have stayed in their own country where the mother and her conjoined offspring would probably have died during childbirth. Why come here and use our advanced and specialised facilities if they don't want to accept the chance of saving the one viable child. Britain should be far stricter about accepting such "hard luck" cases!
I agree and give my support to the parents in this case. Why do we always have to try and make nature so perfect we should learn to accept things the way they are? The bodies natural process had not rejected the children and perhaps they will live longer than we expect in any case they do not have to be separated. When the Buddha was asked "how long is a lifetime" he simply said "one breath." I hope these children have a long lifetime together the quality is in the moment and cannot be quantified by time.
The British legal system has a quaint but laudable view: that the good of the children should be paramount. In cases like these an official solicitor is usually appointed to represent the interests of the children. Until the legal wrangling is finished I should say the chances are slim that anybody not directly concerned is likely to be in possession of all the facts. Probably the most relevant fact is an assessment of the likely quality and duration of the life of the potential remaining twin. Some reports have suggested that the prognosis is poor, in which case the inevitable suffering may well be undesirable. This is different in character from the Christian Scientists who refuse to allow their children even simple medical procedures such as blood transfusions. I am a practising Christian. There's plenty of scripture to support the idea of intervening in cases like these; I think the religious arguments are irrelevant. Poor old judge must feel a bit like Solomon.
What about Jehovah's Witnesses? Do they get the final say on their kids getting blood transfusions or not? That should set the precedent but then again as one message says, religion has a lot to answer for
I think the wishes of the parents should be respected. Why should the courts decide who lives or dies? Nature decides.
The parents of these twins have come to terms with the tragic consequences that nature has dealt them. Theirs beliefs and moral stance allows them to be at peace with themselves. Who are we to tell them otherwise, what right has the medical profession got to seek a legal judgement because they cannot obtain permission from the parents. What is the motivation of the doctors: saving a life or the technical challenges of the operation?
The courts must not put faith in doctors and medicine above the faith in God of these brave parents. I know who I would trust more! Is there not an assumption in the original court ruling that the medical operation will save one of the twins - but how do we know that? If it were to fail - and the risk of that is very real - then both twins will have a premature end. We may as well give doctors permission to kill a terminally ill patient so their organs may be used to save lives if this court ruling is allowed to stand.
The parents have a right to refuse medical treatment in this case, and in any case for that matter. In this case the possibility of the stronger twin to survive separation is virtually nil.
What is surprising is that a health authority is wasting money forcing treatment on those who don't want it, and is no doubt refusing treatment to those who need it due to "lack of funds".
What kind of health service do we have that wishes to operate to kill rather than to save life?
I feel so sorry for the family, it is a dreadful thing. This is not a matter of killing a child, both will die if no action is taken. God has so graciously decided this. This is a matter of saving life. No action amounts to standing by as two people die, even though one can be saved and given a long and full life. Ever heard the one about the good Samaritan!
I think the parents should have at least some say in the final decision. They will after all have to live with either outcome, one daughter or none. I personally don't think the operation should go ahead. Doctors wouldn't kill the perfect liver donor in order to allow a liver cancer sufferer to live, would they. So why is this any different. Also think of the burden on Jodie, when she grows up to discover that she had a sister that was killed to save her life.
In a situation like this, the parents are too emotionally involved to make a rational judgement. I know I can be cold-blooded when expressing opinions of this sort, but for me, the decision boils down to arithmetic: medicine should attempt to minimise the number of deaths. One death, though regrettable, is better - or less worse - than two.
If the parents are prepared to take the responsibility of looking after both children, then their wishes should be respected.
If there is a written law in Britain (or indeed in many other countries) which addresses situations like this? I think not. This is why Britain needs a written bill of human rights which includes subsections on all areas of morality and ethical judicial practice. Situations like this develop because, where no laws or legislation exist to provide guidance we have to fall back on religion and individual opinion to reach a verdict.
If there is one idea that keeps reoccurring throughout most religious teachings, it is that God gave man the intelligence to resolve his own issues, both moral and physical. Who are the parents to presume that they understand the will of God in assuming that he intends the children to die? There are doctors ready and waiting to perform this miracle with His guidance. It shows a remarkable lack of faith and action. If this is a test of their faith, it is surely testing whether they are strong enough to take responsibility for their own actions rather than ascribing this sad episode as part of the Almighty's great 'Plan'.
The twins have not had the chance to say if they are to take on the religion of their parents. Therefore religion should play no part in this decision. The only factors should be the quality of life for the individuals involved.
Isn't one of the problems here the issue of whether or not a parent's religious beliefs should determine whether a child, who has not yet chosen to follow that belief, should live or should die? Looking at it another way, let's take the hypothetical case of similar parents who come to the UK from another culture, and another religion, who believe that the first born child should be sacrificed to whatever god they worship. Would the people currently arguing for the parents still feel it should be up to them?
I'd have thought that it would be clearly against all medical ethics to attempt an operation that would result in the certain death of another human being. To proceed with the operation with this in mind is clearly against the common good, and morally unacceptable. The ends must NEVER justify the means. What right does a surgeon have of denying the sacrificial twin of several more weeks of life ?
This is a tragic case. However, I support the parents. It is never right to deliberately do evil no matter what the justification is. Jeremy Baker writes that "it is the future of the child that is the most important". Which one?
This is extremely difficult ethical and moral issue. Nobody should be blamed for differing opinion. I see it this way: If the children are not separated they will die out of natural cause. If they are separated one is killed by administrative decision. Try to create a moral standard out of that. It has to be the parents who have the final say on such a matter because they have to live with that decision.
Yes, the parents should have the final say. I can't imagine the guilt, sorrow and anger that these parents and the surviving twin will suffer the rest of their lives knowing that one little girl died to save the other.
I am not a parent yet but I cannot understand why these parents
would knowingly risk losing both babies instead of cherishing the one which should survive.
If they were my children I would rather have one healthy baby than none at all.
I think the whole situation is extremely sad.
However I suppose it is ultimately the parents' choice as they are the people who have to live with the fact that they sacrificed the life of one of their children to save the other one. They themselves will have to face opposition to what ever decision they make, which will be very difficult whilst grieving for one or both of their children.
Natalie Quinn, Scotland
Absolutely ridiculous! What quality of life are the two children going to have if they remain joined? Why kill both, if one can be saved? Religion has a lot to answer for....
John B, UK
Of course they cannot have the final say in such a matter. I can think of no other circumstances where the authorities would sit back and allow anyone to make a decision which would inevitably result in the loss of two lives where medical intervention could avoid a death.
UK law has always maintained the stance 'thou shalt not kill'. The Hippocratic oath says exactly the same. There is no doubt that the separation of these two
children will kill one of them, therefore it is morally wrong to even try.
Let us respect their wishes as PARENTS, let them love both children as they want to and give them some dignity. By forcing them to take a child's life to allow another to live a life of questionable quality I find particularly callous and cruel and only British justice could of concluded this in the first place. Let's spare these parents years of hardship as that is what they want and let these children live out their days in peace. It is Gods will.
Philip Levy, UK
The parents talk of letting god decide the fate of their children - yet they came to this country seeking human assistance with the birth in the first place.
Whilst you have to understand the parents wishes, it's the future of the child that's the most important, the operation must go ahead.
05 Sep 00 | Health
Expert to see Siamese twins
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