Post inspired by this article: http://www.cbhd.org/resources/healthcare/hollinger_2000-09-14.htm
In 2000, conjoined twins were born in England and their medical status generated much concern. This set was conjoined at the lower abdomen so that one of the girls, (lets call her Mary) was totally dependent on the other (Jodie) for cardiac and pulmonary support because the twins’ lungs and heart resided in Jodie’s part of the body. The dilemma came when doctors informed the parents that if they kept the twins conjoined, they would both die in 6 months, but if they separated them, Debbie would die instantly but Jodie could live for much longer. Difficult questions quickly arise: should the parents save Jodie by killing (should it be called that?) Mary? Should both lives be treated as intertwined, with potential lifespan as an arbitrary and inapplicable concern, so that both girls should live as long as possible without inciting the (unnatural or pre-term death of one of the girls? Who has the authority to decide this?
The author of the article that incited this post, Dennis P. Hollinger, presented five reasons as to why the parents should elect to do the surgery and should attempt to save Jodie’s life at the expense of a few more months of Mary’s life. I want to address his second point that because Mary would not be alive if she weren’t conjoined to her sister, it is justified to allow her to die by un-separating them because their connection is unnatural while separation, and thus its consequences, are natural. I think that Hollinger’s argument missed the crucial point that Mary has mental activity and thus she is an autonomous and legitimate person. Just because her organs are not hers (just like someone on life support or with organ transplants) does not mean that the benefits from those organs are illegitimate.
This case not only presents a very difficult and quite possibly a lose-lose situation but also a situation that, I feel, is mostly complicated because it has to juggle the divergent interests of the multiple parties. Until we determine clearly who is in charge of these situations and what capacity of control they hold, the continued complexities will compound and thus we must continue to try to sort out the debate of what is ethical and who, especially in difficult situations, has the authority to decide what’s ethical.
3 comments:
I understand your point that Mary is an autonomous being whose right to life should be respected, but Jodie is also an autonomous being, and denying her the care she requires is a violation of her autonomy. Mary will die no matter what: she will die if the twins remain connected, and she will die if the twins are separated. Jodie has a chance at a future and a life. Denying her that future is wrong. There are really only two options in this case, allowing both twins to die or working to give one twin a chance. If there was any chance that the twins could have a healthy life conjoined then perhaps the resolution would be different, but in this situation it would be wrongful to Jodie to deny her a future if there is even a remote chance that the work of the doctors can save her.
Question to Mary:
Scenario - there are two survivors on an island, and the food supply can only keep one alive for one year, after which a boat will come around and rescue him while making its annual cruise. However, if both of them consume the food, they will both starve at the end of six months. Would you, if given the option, shoot one of them in order to save the other one?
Answer to Alex:
I would use the gun needed to shoot one of them to go hunting on the island for wild pigs to feed everyone for the year.
I just wrote a post about practicality vs. ethics and I believe that this is a situation in which practicality trumps ethics. The problem, I believe, with Alex's situation is that it is not realistic (just like the doctor harvesting 5 organs from a healthy man). I don't believe in using non-realistic situations to derive morality and to solve questions of ethics.
The key question is: if you were the parents of these twins, what would you do? As the parent, you make the decisions for your children. You make decisions, you are active. You would not simply sit around and watch both twins die after six months. It is sad and it may be unethical, but in practice, as a parent, you would save one life.
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