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Bacilli

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Suppose that two babies are born joined, and sharing certain organs. Operating will certainly kill the weaker of them; but left without intervention they will very probably die. Is it permissible to operate? Is it obligatory?
I would like to hear your opinions/arguments/resolutions in relation to this situation.


Thanks.
 

Rafy

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This very question was dealt with in the UK case of Mary and Jodie.

http://news.bbc.co.uk/2/hi/health/937586.stm

Jodie and Mary were ischiopagus conjoined twins (joined at the pelvis) and shared a heart and a pair of lungs. The Court of Appeal was asked to decide whether it was lawful to perform surgery to separate them, when the separation would kill Mary. If the operation did not take place there was evidence that both would die within six months.

The court proceeded on the basis that the potential charge would be murder in that, although the girls were physically joined, they were separate "lives in being". The court decided that the operation would be lawful. Ward LJ. concluded that, by analogy with self-defence, it was lawful to kill Mary because she was, albeit lawfully, killing Jodie. Ward reasoned that causing Mary's death did not breach the public policy of "sanctity of life" because of the "quasi self-defence", but Brooke LJ, rejected self-defence because Mary was not unlawfully threatening Jodie's life. He concluded that necessity rather than duress of circumstances would apply because the doctor's will was not being overwhelmed by the threat. Instead, the doctors were making a rational choice to adopt the lesser of two evils, i.e. the death of one rather than the death of both twins. Ward LJ. reasoned that separation surgery was clearly in Jodie's best interests, but not in Mary's best interests, because it denied her "inherent right to life." Given the conflict of the children's interests and the consequent conflict in the doctor's duties to each child, there was "no other way of dealing with it than by choosing the lesser of the two evils and so finding the least detrimental alternative." Jodie could benefit from the surgery to enjoy probably a near normal life; refusal to allow separation would result in the death of both twins. So "the least detrimental alternative" was to allow separation.
Its a fascinating question, 'do you kill one to save the other, or do you let two die?
I mostly agree with the reasoning and conclusion of the judges. The course of action that would result in the least detriment would be to seperate. Best to have one alive, than both dead.
 
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KFunk

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A few things:

- I generally don't buy into the 'standing back and not doing anything doesn't count as killing' stance. E.g. if you can push a button to save a life but choose not to then I think you are culpable (of course, many disagree with me on this).

- Given the above my rephrasing of the problem is 'Kill two babies, or kill one while saving the other'. Put this way I think it is a simple choice that you save one child at the expense of the other. As to which one to save? Either go with the one most likely to survive or, if that cannot be discerned, flip a coin.

- I would acuse those who would rather let both die than forcefully kill one child as having a 'dirty hands complex' whereby they give priority their own moral 'purity' (over the performance of an action which, while having a morally worthy end, involves dubious means).
 

Serius

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It depends how you weigh up life. In a practical situation, i tend to think its hard to place a value on life. For most of my arguments i come from the stance that there is a value, e.g 2 lives are worth more than one, but in a real life situation i dont know if i could make that decision.

Choosing to kill a baby... i dont think i could do it, even if it meant the other one lived because of it. Sitting back and either choosing to do nothing or not making a choice [effectively the same thing] does not make you responsible for them dying, so i would go with that.

Its like with superman or any hero plot where they can either kill one person[not a badie] that would save a catastrophe or not save them and as a result a few thousand die. Do you turn into a murderer to save others? maybe if that one person you kill is actively harming the others, but if they are innocent how can you make that choice? Would not the law still prosecute you as a murderer?

Sometimes a line needs to be drawn, but i cant draw it. Its why i pay the government to do it for me.
 

ur_inner_child

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Serius said:
Sitting back and either choosing to do nothing or not making a choice [effectively the same thing] does not make you responsible for them dying, so i would go with that.
I'd disagree. If you were an onlooker, sure. You have nothing to do with it. But if you were the mother or father, I'd be inclined to call you a bad parent.
 

_dhj_

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I don't like the fact that the 'right to life' argument automatically assumes centre stage even when the subject matter is a dire situation such as this; but in the case of another type of emergency where an accident victim refuses a life saving blood transfusion on 'religious grounds', the medical practitioner can be liable for saving the life of the victim. I don't like the fact that aloof concepts like 'right to life' and 'right to choice' are shoved into certain circumstances where the results of their strict application contradict 'common sense' morality.

Medical practitioners are generally morally upstanding individuals and strict legalism and tunnel vision morality can impinge on their duties with adverse impacts to public policy. In this case we ought to remove uncertainty by imposing an obligation to perform the operation to save one child's life, and to render failure to act a wrongful ommission incurring civil liability. Who in their right mind would regard allowing both children to die as the moral thing to do? You only reach that result by a logical application of arbitrary moral principles that perverse rather than solve the issues.
 
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Serius

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ur_inner_child said:
I'd disagree. If you were an onlooker, sure. You have nothing to do with it. But if you were the mother or father, I'd be inclined to call you a bad parent.
We are talking about the doctor here right? or are we extending what i said to a broader sense...

Because a parent not being able to choose which of their children to kill to save the other, or choosing not to kill either doesnt make them an unfit parent, i think it just makes them normal. Logically you can reason it out that killing one is the best option, but alot of people wouldnt be able to do it because emotions get in the way. I dont know if i could become a murderer to save someone else.
 

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