The ultimate test of faith

As the parents of Siamese twins argue against separation on religious grounds, BBC News Online looks at the uneasy relationship between faith and medical ethics.

Two baby girls joined at the lower abdomen lie entwined in a hospital incubator in Manchester. One must die so the other can live.

Jodie and Mary - false names used by the High Court judge who gave surgeons permission to separate the girls - share a heart and a pair of lungs. Unless the girls are separated, both will die within months.

The ruling to operate was made by Mr Justice Johnson

For their parents, who came to the UK from a remote Mediterranean community, the operation is not a question of life or death. It is a test of their faith.

The couple do not want the operation to go ahead because they believe it should be up to God - not the medical team at St Mary's Hospital in Manchester - to decide their daughters' fate.

This belief is an intuitive interpretation of their Roman Catholic faith, that it is wrong to do evil - sanctioning the death of a child - even though it could result in good.

It is the latest case in which medical concerns have come to blows with strongly-held religious beliefs.

In May, two baby girls who shared a heart, just like Mary and Jodie, died in Sicily after an operation to separate them.

National debate

The fate of the Peruvian twins sparked a national debate in Italy.

Although the parents had made the difficult decision to go ahead with surgery, the specialist leading the medical team pulled out on moral grounds.

Jehovah's Witnessess believe blood should not be intermingled

The operation eventually went ahead, but the twins died within six hours of each other.

In the conflict between faith and science, few church leaders go as far as spelling out which medical procedures are right and which are wrong.

A notable exception are the Jehovah's Witnesses, the Christian sect with six million followers worldwide.

Since 1961, the sect has banned the faithful from accepting blood transfusions. Before then, the procedure was regarded as a matter of conscience.

[To abstain from things] polluted by contact with idols, from fornication, from anything that has been strangled and from blood.

Acts 15:20

Taking their doctrine from Acts chapter 15, verse 20, Jehovah's Witnesses believe that as life is a gift from God, blood should not be intermingled.

This year saw a slight shift in their position on transfusions. The church leaders ruled that although followers accepting a transfusion would no longer be excommunicated, it would be tantamount to self-expulsion - the Witness would automatically revoke membership of the church.

In the 1940s and 50s, vaccinations were also prohibited, and, in the 1960s and 70s, organ transplants were banned, as were cornea transplants.

Earlier this year, doctors in Leeds skilfully side-stepped the transfusion issue for a Jehovah's Witness couple when they carried out a kidney transplant between a man and wife without either having a blood transfusion.

Elsewhere though, the issue of donating organs for transplantation is itself an ethical maze.

The Pope is a fierce opponent of human cloning

In the 1960s and 70s, Protestant and Catholic donors would often specify no organs should go to members of another religion. Religious objections are still commonplace today, although no faith has a clear policy on the subject.

Last month, the Pope endorsed voluntary organ donation for Catholics, calling it "a genuine act of love".

Among Asian communities in the UK, there has been a common misconception that organ donation is not allowed. Many believe that after they die, their bodies should be as complete as when they were born.

Five years ago, leading Muslim clerics in Birmingham, a city that is home to one of Britain's biggest Asian communities, issued an edict consenting to the principle of donation.

Human cloning

But the ceaseless march of science means as each moral dilemma is laid to rest, a whole host of new ones loom.

Today, none is more dominant than the issue of human cloning, which opposition groups typically describe as "playing God". The Vatican has come out as a staunch opponent of human cloning - in August the Pope said the practice of growing human cells for transplants (therapeutic cloning) was "not morally acceptable".

The Anglican Church has remained silent on the issue, although it is thought the Archbishop of Canterbury and other bishops are opposed to the practice.

This is clearly at odds with recent government decisions in Britain and the United States in favour of therapeutic cloning.