Re A (Children) (Conjoined Twins: Surgical Separation)
Encyclopedia
Re A (Conjoined Twins: Surgical Separation) [2001] Fam 147 was an English Court of Appeal decision on the separation of conjoined twins
. The case raised several legal, ethical and religious dilemmas including whether it would be permissible to kill one of the children to save the other. and whether it was permissible to act against the wishes of the twins' parents. "Jodie" and "Mary", who were born on 8 August 2000, were pseudonyms given to conjoined twins
, Rose and Grace Attard, who were joined at the pelvis. The medical evidence indicated that Jodie was the stronger sibling who was sustaining the life of Mary. Mary had only survived birth due to a shared common artery that enabled her sister Jodie to oxygenate blood for both twins. If surgically separated Jodie could live but Mary would die. However, should they have not been separated and there would have been a chance that they could have died before they were one year old.
where it was declared acceptable to remove life support. Johnson ruled that separation would not be murder but a case of "passive euthanasia" in which food and hydration would be withdrawn.
The Court of Appeal rejected this analysis but the three judges who presided over the case gave very different legal reasoning. Lord Justice Alan Ward invoked the concept of self-defence suggesting that "If Jodie could speak she would surely protest, Stop it, Mary, you're killing me." Lord Justice Brown relied upon R v Dudley and Stephens
and invoked necessity as a defence. Lord Justice Robert Walker focused upon the intention of the surgeons in concluding that surgery could go ahead.
Conjoined twins
Conjoined twins are identical twins whose bodies are joined in utero. A rare phenomenon, the occurrence is estimated to range from 1 in 50,000 births to 1 in 100,000 births, with a somewhat higher incidence in Southwest Asia and Africa. Approximately half are stillborn, and a smaller fraction of...
. The case raised several legal, ethical and religious dilemmas including whether it would be permissible to kill one of the children to save the other. and whether it was permissible to act against the wishes of the twins' parents. "Jodie" and "Mary", who were born on 8 August 2000, were pseudonyms given to conjoined twins
Conjoined twins
Conjoined twins are identical twins whose bodies are joined in utero. A rare phenomenon, the occurrence is estimated to range from 1 in 50,000 births to 1 in 100,000 births, with a somewhat higher incidence in Southwest Asia and Africa. Approximately half are stillborn, and a smaller fraction of...
, Rose and Grace Attard, who were joined at the pelvis. The medical evidence indicated that Jodie was the stronger sibling who was sustaining the life of Mary. Mary had only survived birth due to a shared common artery that enabled her sister Jodie to oxygenate blood for both twins. If surgically separated Jodie could live but Mary would die. However, should they have not been separated and there would have been a chance that they could have died before they were one year old.
Judgement
At first instance, Mr Justice Johnson was left to decide the case without any direct precedents to guide him but reasoned by analogy with Airedale NHS Trust v BlandTony Bland
Anthony David Bland was a supporter of Liverpool F.C. injured in the Hillsborough disaster. He suffered severe brain damage that left him in a persistent vegetative state whereby the hospital, with the support of his parents, applied for a court order allowing him to 'die with dignity'...
where it was declared acceptable to remove life support. Johnson ruled that separation would not be murder but a case of "passive euthanasia" in which food and hydration would be withdrawn.
The Court of Appeal rejected this analysis but the three judges who presided over the case gave very different legal reasoning. Lord Justice Alan Ward invoked the concept of self-defence suggesting that "If Jodie could speak she would surely protest, Stop it, Mary, you're killing me." Lord Justice Brown relied upon R v Dudley and Stephens
R v Dudley and Stephens
R v Dudley and Stephens [1884] 14 QBD 273 DC is a leading English criminal case that established a precedent, throughout the common law world, that necessity is no defense against a charge of murder. It concerned survival cannibalism following a shipwreck and its purported justification on the...
and invoked necessity as a defence. Lord Justice Robert Walker focused upon the intention of the surgeons in concluding that surgery could go ahead.