This article deals with the moral dilemma of a sensational case of conjoined (often called Siamese) twins who were born in Manchester, England, on Aug. 8, 2000. The most controversial issue in this case is whether it is morally permissible to separate them surgically foreseeing that one of the twins will die in order to save the other. I argue that the separation surgery is morally justified.
My argument consists of four steps. First of all, I outline the most significant facts without going into irrelevant details; In this case, the medical indication leaves no doubt that both twins will die within months if not separated; but if separated, one will die immediately while the other could live a long life. Doctors in the hospital insist then on the moral and legal permissibility of the surgery, but the parents have a different opinion and cannot agree to it. So the case came before the courts where the decision whether or not to permit or to refuse the medical treatment would be made. The Supreme Court at last decided for the separation on the 22nd of September, 2000, and the surgery took place in November of the same year. As predicted, one died and one survived.
Secondly, different positions - the pros and cons - on the issue are presented: (1) the parents of the conjoined twins and the Catholic Church .in England oppose the separation. The parents cannot imagine that one of their children should die to enable the other to survive. Supporting this idea, Archbishop of Westminster Cormac Murphy-O'Connor holds that there is a fundamental moral principle at stake. No one may commit a wrong action that good may come of it. Applied to this case, one is not allowed to kill in order to save. (2) Most physicians are for the surgery, and the legal system has also decided in their favor. Appeal is made to the principle of proportionate reason and the doctrine of necessity among other considerations. The issue of intentional killing is also carefully analyzed by the judges.
Thirdly, I will examine various arguments underlying different positions. The point of the examination is not so much an affirmation or denial of certain positions as a critical analysis of their soundness and consistency. Based upon this analysis, I present, lastly, my own arguments, which justify the separation surgery in this unique case.