Meet Jake and Blake. They are conjoined twins.
Jake wants an operation that will separate them. Blake most certainly does NOT want the operation because he will die as a result of it.
Which of the two should have the final say in the matter?
Given that an operation which is SURE to kill the patient would count as murder in most jurisdictions, it’s not a matter of what the twins say. It’s a matter of “no surgeon will touch that”.
Is this an abortion question?
It’s inspired by all the recent abortion debates, but the OP is not intended as a “gotcha”. Sorry, probably should have put that in the OP.
I’m fighting the hypothetical because it feels like a gotcha. Blake is not equivalent to a fetus.
If Blake is lacking a fully formed brain and cannot function without Jake, and if Jake’s health and well being are being affected by Blake, it’s bye-bye Blake
It is interesting to consider cases of actual conjoined twins.
At least in the US, the law has tended to regard each twin of a conjoined pair as individuals. That’s why Abby and Brittany Hensel each had to take a separate driving test, and each have the own driver’s license, rather than having a joint license (if you’re not familiar with the Hensel twins - it is impossible for either to operate a car without the cooperation of the other, they essentially share a singular body from the neck down with each twin having control over only her half).
But the fact conjoined twins are joined do present problems - Chang and Eng Bunker (the famous “original” Siamese twins) were involved in several legal problems during their lives and the courts seemed to have resorted to fines rather than jailing the offending brother because it would, of course, necessitate imprisoning the innocent one as well. (There was also the problem of the more abstinent brother showing up to Temperance meetings drunk because his brother continued to drink…)
So… I would say… (not that anyone really puts me in charge of anything) that if both brothers are of sound mind and adults then we must err on the side of preserving individuals. If conjoined they will most likely continue to live in reasonable health, and dividing them would result in certain death for one of them, they must remain joined.
But if their health is deteriorating and them remaining joined seriously endangers the health of both… there is ample precedent in the medical world for sacrificing one to save the other. If the choices are save one life or neither again, we err on the side of life.
Conjoined twins are sometimes a special case - as I mentioned, there are instances where if the twins remain joined both will die, but an operation to save one of them will result in certain death for one of them.
In 1977 C. Everett Koop (former Surgeon General of the US, but before he had that particular post) took part in an operation of precisely that nature - in order to save the life of even one twin he had to take action that would kill the other. So there are surgeons who will “touch that” in extraordinary circumstances. It should also be noted that precisely to forestall accusations of murder Koop went to court to get clarity on the legal issues, to an ethics committee, and to a rabbi (the twins were from a Jewish family) prior to going ahead with the operation. During the operation Koop himself tied off the aorta of the twin that would not survive, in fact deliberately killing one twin to save the other, because he didn’t feel he could ask anyone else to do that.
Here is a link to a statement written by one of the people involved explaining the moral reasoning within the context of Jewish law. It also addresses the ethics of abortion and how they are related to the case. The OP may wish to read that article.
Koop also wrote about the case, but I read his account in hardcopy many years ago and can no longer locate it. It’s probably out there somewhere, I just haven’t been able to find it. I found it quite moving.
Has there ever been a case when the twins were not babies though? The OP certainly implied that they were old enough to express an opinion, if not adult. All the separation cases I’ve heard of have been on babies due to parental choice, usually because both twins cannot survive, rather than choice of one of the twins.
I’d guess that once they were adult, that’s past the point where surgery fatal to one twin would be considered.
It’s been done here in the US. I was surprised at the time that there was no hue and cry, but it was believed both twins would die if the separation surgery was not performed, and the surviving twin lived for less than a year afterward.
Dr. Ben Carson (Now US Secretary of Housing and Urban Development)was the first neurosurgeon to separate twins joined at the head. While he is not charged with killing the boy, one of the two went into a coma and never came out of it. I think he lived ten years or so. The other twin was profoundly disabled, unable even to feed himself.
It is still customary in the US to describe this as a groundbreaking success.
The boys’ parents had been to hundreds of surgeons, all of whom refused to try the operation as it was extremely likely to kill one boy, and the other would not have a full brain when it was done. It seems to me that the ethical answer was clear, and the operation should never have been attempted.
Blake wants life. Jake wants murder. Case closed.
This argument sounds awful familiar.
If Jake went to a backstreet surgeon, through lack of choice, they may both end up dead.
If they get pulled over for speeding, or running a red light, or an illegal left turn…which one gets the ticket?
And, back to the OP, if Blake decides to kill himself by overdosing on narcotics, but survives, would/should he be charged with attempted murder of Jake?
Forget it Jake, it’s Siamese Town.
I have no idea how that would be sorted out.
Potentially, but then you have the problem of how to punish Blake without also simultaneously punishing the innocent Jake.
Fortunately, conjoined twins seem to by and large law-abiding folks. Not that there is a large sample size.
Except in this case, they are old enough to make this decision on their own.
If they’re speeding, Abby gets the ticket, since she controls the accelerator. Making an illegal left turn is on Brittany, since she does the steering.
nm