Editorials

The separating of conjoined twins

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7264.782 (Published 30 September 2000) Cite this as: BMJ 2000;321:782

A human life has the greatest value, but its loss may be justified

  1. Alexander McCall Smith, professor of medical law
  1. University of Edinburgh, Edinburgh EH8 9YL

    News p 783

    It is rare for judges to comment on the personal difficulties they face in reaching decisions. Unlike doctors, who can freely admit to the anxiety that difficult decisions may give them, judges are meant to remain tight lipped. The controversial case of conjoined twins, recently decided by the Court of Appeal in England, has been different.1 The twins, brought to Britain for medical assessment, need to be separated. Surgery can save one but will inevitably lead to the death of the other twin, who has no effective heart or lung function and who also seems to have brain damage. The parents do not want the twins separated if one twin has to die. At several points the judges involved in the decision made public remarks about sleepless nights. After all, judges are human, and nobody could have found this case anything but distressing. Now, after all the soul searching, we have a decision and, even if the case goes further on appeal, the tide of …

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