Re A (conjoined twins)

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Re A (conjoined twins) was a landmark legal case in the England and Wales Court of Appeal that took place in the year 2000. The case concerned conjoined twin girls, known as Mary and Jodie (not their real names), who were joined at the pelvis. The medical condition of the twins was such that they shared several vital organs, but only Jodie, the stronger of the two, had a functioning heart and lungs. The medical experts opined that if the twins remained conjoined, both would eventually die. However, if they were separated, Jodie had a good chance of survival, whereas Mary, who was entirely reliant on Jodie's bodily functions, would die immediately following the surgery.

Background

The twins were born in August 2000 to parents of Maltese nationality. The parents were devout Roman Catholics and opposed the separation on moral and religious grounds, believing it was God's will that the twins remain together. The hospital, seeking to save at least one of the twins, brought the case to court to obtain legal permission to proceed with the operation.

Legal Proceedings

The case, formally known as Re A (Children) (Conjoined Twins: Surgical Separation) [2000] 4 All ER 961, was heard before the Court of Appeal of England and Wales. The primary legal question was whether the doctors could perform the operation to separate the twins without the parents' consent and, if so, whether such an operation would constitute murder.

The court had to balance complex ethical, moral, and legal issues, including the right to life of both twins, the principle of doing no harm, and the parents' rights to decide on their children's medical treatment. The judges ultimately ruled in favor of the separation, reasoning that while the operation would lead to Mary's death, not performing the operation would result in the deaths of both children. The court held that the operation could be considered lawful as it was intended to save Jodie's life, which was seen as an act of self-defense.

Judgment

The judgment delivered by Lord Justice Ward, Lord Justice Brooke, and Lord Justice Robert Walker was groundbreaking. They concluded that the operation would not be unlawful, as the primary intention was to save Jodie's life, not to kill Mary. This case is often cited as a significant example of the doctrine of "double effect," where an action that has both a positive effect (saving Jodie's life) and a negative effect (resulting in Mary's death) can be ethically permissible if the positive effect outweighs the negative.

Impact and Legacy

Re A (conjoined twins) has had a profound impact on medical ethics, law, and the practice of medicine. It raised important questions about the limits of parental rights in medical decision-making, the rights of patients, and how to ethically balance competing interests in life-and-death medical decisions. The case is frequently discussed in academic and legal circles and is considered a landmark decision in the field of medical law.