The gist: conjoined twins were born last month to a European couple of undiscolsed origin. The girls are attached at the pelvis; “Jodie” is purported to be strong and alert, but “Mary” depends on her sister’s heart and lungs (one set between them).
The parents sought out medical care in Britain superior to their native country’s, where the twins would most likely have perished. Now, British court wants to force the parents to consign the twins to an operation that will potentially save Jodie but indubitably kill Mary.
If no operation is performed, there is an 80-90% chance both girls will die.
The parents do not want the operation performed, contravening with a religious rationale—in sum, it is not God’s will to kill one to save the other; lives must be given equal opportunity.
This case invokes questions similar to those conjured in abortion debates. As for myself, I waffle—if the couple earnestly wanted their children to live or die per natural/divinal selection, why did they seek care in Britain in the first place…?
I read in a book the other day that the most popular form of birth control in Britain in the 19th century was infanticide. But, killing one person to save another is wrong, even if there is only a 10-20 percent chance that both would live. If Mary could give consent, that would be one thing, but since she can not I think leaving it to the fates isn’t such a bad idea morally. Tough one though.
This is a thorny issue. I can’t fault the parents for seeking the best medical care for their children, they were doubtless unaware of the consequences that could follow.
This is one of those hard-to-make decisions that has no good answer. I suppose I would rely on statistical information if no other data is provided, i.e.
What are the odds of the one child surviving after the operation? It seems that 80-90% odds that both will die is almost tantamount to a hopeless situation. And survive until what age (without the operation), anyway?
Hmmm…“quality of life” issues would suggest that leaving them as conjoined is not the optimum solution. However, it would appear from the evidence at hand that they are surviving healthily as conjoined twins for the moment.
If somebody appointed me judge here, I would say not to kill Mary for Jodie’s benefit. But be prepared to operate when a child their age dies with intact heart and lungs. Then transplant them into Mary and do the disconjoining operation as soon as she is stable.
Of course what Polycarp says is reasonable. Again, to me it boils down to - what are the chances of being able to have both children survive, vs. the chances for a single child?
Assuming the following:
chances for both children to survive - 10%
chances for one child to survive - 90%
Then I would say that a government may be justified in ordering the operation even in spite of the disagreement of the parents. If the percentages were 50% then there would be no reason to compel the children to have to go through the operation. I don’t think that “we should let God decide” should be a valid reason for foregoing an operation if there are clear medical reasons for doing so.
Respectfully, Polycarp, I think your resolution is too idealistic. Granted, there’s no brimming cornucopia of medical data being spilled here, but implicit is the prediction that only Jodie has a reasonable chance at life.
Also, Mary would not be “killed” per se. The operation would simply remove the twin with the heart and lungs. Although I suppose you could argue the semantics of that one till you turn plaid in the face. Hmmm…
At the risk of a highjack, Arnold I must submit that I don’t believe the government should overule the rights of the parents especially when it comes against a religious objection for a particular medical procedure. There have already been several threads touching on this from several sides.
Leah, I feel reasonably sure the parents were trying to do their best to do whatever they could to insure the safety and perhaps the quality of life for BOTH their daughters. I try to imagine their anguish in learning the actual situation. Thankfully I have never nor ever will be in that position…therefore have no idea which way I would “waffle.”
polycarp, while I think your reasoning is valid, I don’t think the facts are quite straight. the quality of life issue is not an issue at all, because, joined together, they only have a limited life span. Most conjoined twins are of the “one is strong and healthy and the other is definitely not” variety. As Mary grows weaker and weaker, her systems will start to shut down. Since she is still attached to her sister, Jodie’s systems will falter as well. The two will probably die of heart or lung failure within hours of each other.
There was a case much like this a few years back at the Childrens’ Hospital over my way. I believe the twins were ultimately separated, but I can’t recall if the healthier of the two survived.
It is exactly cases like this that make me sure the state should not meddle in such intimate and heartbreaking affairs. Abortion comes to mind. Although I am strongly pro-life, and would do everything in my power to keep a child who I helped conceive, I cannot and will not make a judgement about others in a similar position. Interestingly enough, Catholic doctrine would agree with me (at least in the extreme cases). For example, if an abortion needed to be performed lest the mother die an untimely death, the Church takes no position (although certain philosophers and theologians within the church may not follow suit).
I say the British Government should not be handing down judgements to two parents struggling with an ultimately heartbreaking situation.
The English courts (not the British Government) are adjudicating between the rights of the parents, ‘Jodie’ and ‘Mary’, all of which are in conflict with each other. That is what the law courts are there for.
We will have to disagree on this. My opinion is that if the situation is clear-cut (such as “If this medical procedure is withheld there is a 100% chance the child will die”) the parents’ religious considerations should be swept aside. The problem in my mind is where to draw the line, which is of course the difficulty in this case, and without more knowledge of the prognoses for the different procedures it’s very difficult to make a decision.
Arnold, I understand your position, but I submit that in the vast majority of cases there is no clear-cut solution when dealing with medicine. Granted, the percentages may greatly favor one course of action over another, but the parents are RESPONSIBLE for the upbringing of their children and their welfare, not the state. What is the result if a state sanctioned procedure leaves a comatose child? Who pays for the care? Does the state now insist that the parents pull the plug? Does the child become a ward of the state? Does the state pull the plug? Where is the separation of church and state?
Ideally, the parents should make the best decision. But who determines “BEST” in each case? Again, the parents have the moral and LEGAL duty to raise and care for their children and until the perfect dividing line (“where to draw the line” in your words) is found, I think that the state should keep their nose out of the heartrending decisions that parents may have to make at some time.
(Note: Dealing with stupid and irresponsible parents is another thread :))
What is the result if a state sanctioned procedure leaves a comatose child? Who pays for the care?
If the parents refuse to pay for it then the state should pay for it.
Does the state now insist that the parents pull the plug? Does the child become a ward of the state? Does the state pull the plug?
Here comes the issue of “what are the chances of the child ever coming out of the coma?” I personally think that as long as there is a chance of the child coming out of the coma life support should continue, which I think (absent a parent’s decision) is the policy followed by hospitals, but I don’t know for sure.
Where is the separation of church and state?
This in my mind is exactly why religious beliefs should not come into play in the case of a child’s medical care or upbringing. If a doctor (or a panel of doctors) determines that a child needs a blood transfusion (for example), then it shouldn’t matter if the parents object for religious reasons or non-religious reasons.
I disagree with the attitude “Who knows what’s best for a child? Obviously the parents.” For example, if my child is sick, I don’t know what treatment they need, I’m not a medical professional. The doctor probably knows what’s best for them, not me. Of course a parent should make a decision concerning a child’s welfare, but in some cases another person is more qualified in making the decision.
Arnold, I have a question for you (and for anyone else who would agree with you). Please keep in mind that yes, I disagree strongly with you, but it is a not terribly abiding opinion.
Why is there such a moral impetus to utilize new technologies? The ability to separate twins of this variety is a rather recent development. Do we have an imperative to change our beliefs as soon as the future becomes possible?
Look at a more black and white case (favorable to your side). What of antibiotics? If a parent of yore would pray for their child to get better, and prayer was for the most part the most efficacious method of health-improvement that people knew of, should they be forced to change their moral outlook?
Should we insist that all countries which rely on non-western medicine be forced to start treating their children with our methods, or risk sanctions or revocation of trading benefits?
Lastly, if a parent truely beleives that an act is evil (the killing of one of their children), does or should the government force the act upon the family?
Well… id say this is clear cut… the twins nor the parents are British they just went there for medical care. Maybe this is really Britan seeing how much it can get away with?
Neither the children nor the parents are British but they are being treated in a British hospital. It is the hospital which wants a ruling on the legal status of the possible courses of action.
Yes. If a new medical treatment is available that can save someone’s life, it is criminal to refuse that treatment to an individual because you personally think it’s against your moral code.
If a group of medical experts agreed that the treatment with the best chances of success is antibiotics instead of prayer, then antibiotics should be used. Here of course we get in the issue of “How much will the antibiotics help vs. what are the potential negative side-effects?”
If a country can have access to better medical treatment, then it would be remiss to deny them that medical treatment. If studies show that their non-western medical treatment is as effective as the western medicine there would obviously be no benefit in forcing a change. Most countries that don’t use modern medical techniques seem to do so because a lack of funds, not because of a lack of belief in the efficacy of surgery, vaccines, etc…
Yes, if medical professionals determine that both children would die anyway, and that by killing one child you can save the other.
Arnold, the idea of the government intervening in the personal decisions of parents is disturbing to me because there is NO black and white to these issues. I find the notion [expanding the thread a little here] of trying to protect from harm, injury, or bad circumstance, EVERY kid, EVERY user of all kinds of tools or implements, or EVERY stupid moron who fails to use common sense is a high and lofty goal. But in doing or trying to do so, inevitably the rights of countless others are ground into the dust when establishing the criteria. Secondly, the costs associated with trying to enforce the rules and regs related to eliminating the small percentages that are left rise astronomically as the percentages get smaller and smaller. Some will always fall through the crack. That is indeed unfortunate and undesirable, but I submit IMHO that the moral, social, and economic condition of the country would be much better off if the government would kindly keep its snotty nose out of areas in which it has no business.
I only just read that the family are not British nationals and at the risk of being accused of a cop-out I really do not think that British courts should be ruling on this.
We do not have the cultural moral background which these parents are from to make a decision.
Put another way, how would you feel if the children were US citizens and British courts were making a decision not only about the lives of the children but also an implied comment on US moral culture.That is to say British courts decide to junk the sensitivities of the US in favour of their self-assessed morally high values.
If this condition had been detected early on in pregnancy how would the Catholic faith, which is that of the parents, have reacted to this ? Would it have been percieved as an aborted pregnancy ?
I am not sure of the US position as regards the Supreme court but I believe that it effectiveley makes laws that apply to all US citizens whereas British court do not have the same constitutional role, so that they can rule one thing in one case and it does not have to be applicable to all general law.ie an ad-hoc law for one special case.
I looked at your point Phil and can see something in it, it is not like the parents have wilfully neglected their children, parents already have the right to deny potentially life-saving treatment to their children, they can refuse vaccinations for them, its just that the hazard to health is not as immediate, in fact being too lazy to bring your children to attend vaccination programms in my opinion is greater evidence of neglect than these unfortunates have ever shown.
I’ll repeat a point I made in the other thread and that is - what if the children are separated and the survivor, contrary to medical predictions, does badly - the moral basis for the decision will suddenly be looking somewhat weak.
I am not saying the parents are right but where medical science does not have all the answers then their wishes should prevail.
So what should happen if parents decide that their religion dictates beating their child for discipline? Should the government intervene? Or are you speaking only of medical decisions? Then suppose a child has a ruptured appendix and the parents don’t want surgery because they think they can heal the child through prayer? Should the government intervene?
In the USA (or in my country of origin, Switzerland) the government would intervene in both of the situations I have mentioned above, and I believe rightly so.
I agree. Which is why the decision should depend on the medical prognosis as offered by experts in the field. If the odds of a single child surviving are very high, and the odds of the joined children surviving very low, the operation should be done even without the approval of the parents.
A similar argument could be advanced against any surgical procedure. Nothing is 100% predictable. The child being treated for the ruptured appendix can die on the table. Nevertheless the odds are much greater if the operation is performed.