Intended for healthcare professionals


Twins' lawyers may demand change of venue for operation

BMJ 2000; 321 doi: (Published 07 October 2000) Cite this as: BMJ 2000;321:853
  1. Clare Dyer, legal correspondent
  1. BMJ

    The way was cleared last week for conjoined twins born in Britain to Maltese parents to be separated, when the unnamed parents announced that they would not contest an Appeal Court ruling that the operation should go ahead.

    The couple came to Britain for the delivery after a scan showed they were expecting conjoined twins. Soon after the birth last August, they found themselves embroiled in a High Court battle after refusing to consent to an operation to separate them.

    The twin girls are being cared for at St Mary's hospital in Manchester, where they were born. The court ruling assumes that surgeons at St Mary's will carry out the operation, and the Central Manchester Healthcare NHS Trust said this week that their plans had not changed.

    But as we went to press, lawyers for Jodie were considering whether to bring the issue of where the operation should take place back to the court.

    The trust denied a Sunday newspaper story that doctors at St Mary's were wavering in their determination to operate because of continued opposition from the parents, and that the lead paediatric surgeon had told colleagues he was not prepared to operate because of concerns that both babies would die “under the scalpel as the world looks on.”

    The parents are thought to have gone to St Mary's because a doctor in their home country had links with the hospital and advised them to go there. But it became clear during the legal battle that St Mary's has never carried out the sort of operation the twins need.

    Great Ormond Street Hospital for Children in London has operated on 12 sets of conjoined twins, with half the children surviving. This hospital was brought into the case to give a second opinion at the request of the Appeal Court judges.

    Last week Lewis Spitz, professor of paediatric surgery at the Institute of Child Health and a consultant at Great Ormond Street, wrote to the Department of Health asking for the hospital to be recognised as the lead centre of excellence for the separation of conjoined twins.

    A spokeswoman for Great Ormond Street said: “There was no criticism of St Mary's implied in this at all. It was just his decision. We see one set of Siamese twins a year.”

    The twins, named Jodie and Mary during the court battle to hide their real identities, are joined at the abdomen. Mary has no functioning heart or lungs and no prospect of survival, but doctors say Jodie could have a normal life, though with some disabilities. Both twins will die if the operation is not carried out.

    The main issue in the complex legal battle was whether it would be lawful to operate to save Jodie when the operation would inevitably kill Mary.