Viewpoint Heartbreaking ruling on conjoined
twins
By AUSTEN IVEREIGH
What is this creature in the eyes of
the law? the judge asked a packed London courtroom in mid-September,
pointing to an artists sketch of 6-week-old twins. The babies, named
Jodie and Mary by the court, lay flat on their back, a single trunk with a head
at each end. Their legs protruded out from either side. Seen from above, they
formed a cross.
At issue was the lawfulness of doctors at a hospital in the north
of England separating the twins on an operating table, against the wishes of
their Maltese Catholic parents. The fuse had been lit: Jodies heart was
bearing the strain of her sister. Without surgery to separate them, both would
be dead in months. But the surgery would kill Mary, and this the parents could
not agree to. With the parents and the doctors at odds, the law would decide.
Once inside the courtroom, Jodie and Mary became a seminar in lifeboat
ethics.
If the answer to Lord Justice Henry Brookes question was
that Mary was a human being, deserving of the protection the state must offer
equally to all people, with what moral and legal justification could her life
be sacrificed, as the doctors wished, to give her sister a normal life?
The first answer was that Mary was a pitiful creature,
parasitic on her sister. This was the view of Justice Robert Johnson in August,
who ruled that the operation was like switching off a life-support machine
(Jodie) attached to a patient destined for death (Mary). Ethicists
were alarmed: These were reasons for euthanasia. But a number of commentators
still believed the operation could be justified by a choice of the lesser evil.
And some Catholic ethicists cited the doctrine of double effect: Marys
death was the foreseen but unintended consequence of an operation intended to
save life.
But the principle of double effect did not apply, the archbishop
of Westminster, Cormac Murphy OConnor, later told the Court of Appeal.
The good effect was here produced by means of the bad; it would be both
foreseen and intended that the operation would cause Marys death. It
would transgress a basic principle of British law, the archbishop went on to
argue: that it is never permissible to kill an innocent person, even to save
the life of another.
The three appeal judges seemed at first to agree. After
criticizing Johnson, who was wrong to find [Marys life] was worth
nothing, Lord Justice Alan Ward said there was no place for euphemism. He
had been awake at night, he told the court, pondering this awesome question:
Could it be right and lawful to save Jodie by murdering Mary?
But having endorsed sanctity of life principles, the appeal judges
went on to perform a Houdini act. Each twin had an equal right to life, they
ruled Sept. 22, so the right of each goes into the scales, and the scales
remain in balance. Other elements, such as the value of the surgery and
its outcome, had to be added. When this was done, the balance is heavily
in Jodies favor.
The other arguments and analogies in the judges 120-page
judgment seem strained and unpersuasive. One argued -- oddly, given the nature
of the operation, and its foreseen effect on Mary -- that the surgery would
give the childrens bodies the integrity that nature denied
them. Another said the operation was in the best interests of
both twins, while Mary, said the most senior judge, could be compared to a
9-year-old in a playground with a machine gun. She was an unwitting yet
unjust aggressor on Jodie.
At the heart of the judges thinking was that the twins
rights and interests were antagonistic. If Jodie could speak, said
Ward, she would surely protest, Stop it, Mary, youre killing
me.
But Jodie would have said no such thing, according to a movie
playing at the time in London. Twin Falls Idaho concerned
30-year-old twins conjoined, like Jodie and Mary, at the abdomen. Although it
meant they would both die sooner, the twins in the film avoided surgical
separation, because while it would free the stronger, it would kill the weaker.
We checked in together, they say, and were going to
check out together.
Jodie and Mary were not given that chance. As they neared the end
of the marathon 20-hour operation Oct. 7, teams of surgeons at St. Marys
Hospital in Manchester severed the aorta carrying Jodies blood to Mary.
The hospital later stated -- with breathtaking dishonesty -- that Mary had died
despite the best efforts of surgeons.
In approving that surgery, either the court had chosen the only
reasonable option, the lesser evil in heartbreaking circumstances, or it had
made a catastrophic, and possibly far-reaching, ruling. But whichever view
people took, no one felt comfortable that a British court had labeled a
3-month-old baby an aggressor and ordered Marys death.
Later her sister Jodie was said to be recovering, but still
critical. To reduce her post-operative stress, the doctors said, they have
placed a mirror beside her.
Austen Ivereigh is assistant editor for The Tablet, a
lay-edited Catholic periodical published in London.
National Catholic Reporter, November 24,
2000
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