Faith & Reason: The Siamese Dilemma: Science vs Superstition? ; the Medical Facts May Look Cut and Dried. but Sacrificing the Weak for the Strong Is the Ethic Which Lies Behind Social Darwinism and Fascism

By Storkey, Elaine | The Independent (London, England), September 9, 2000 | Go to article overview
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Faith & Reason: The Siamese Dilemma: Science vs Superstition? ; the Medical Facts May Look Cut and Dried. but Sacrificing the Weak for the Strong Is the Ethic Which Lies Behind Social Darwinism and Fascism


Storkey, Elaine, The Independent (London, England)


IT IS encouraging to know that judges have sleepless nights. Lord Justice Ward this week made public the fact of his insomnia under the weight of a life and death decision, as the Court of Appeal continues its hearing on the proposed separation of the Siamese twins.

Initially, the case looked cut and dried. Parents from an "unidentified and remote" southern European community (most reports implied "backward") came to Britain for medical help. Their Siamese twins have only one working heart and set of lungs between them. Jodie, the stronger twin, might survive on her own, but not joined to Mary. Therefore, from the point of view of the doctors who wanted to do the operation, and the court who ruled in their favour, there was an obvious solution: perform an operation to separate the twins. Jodie could have the heart and lungs and go on her way with the chance of a reasonable quality of life; Mary, sadly, is going to die anyway.

The only drawback to this plan was that the parents disagreed. Their "strong religious convictions" (most reports implied "unscientific superstition") got in the way of good medical sense.

A conflict between medical opinion and parental opinion is not new. Occasionally, parents do have their right to decide taken away from them when "strong religious convictions", however sincerely held, work against the well- being of their children. Doctors are professionally required to act in the best interests of patients. They must be allowed to administer life- saving drugs, perform surgery or give blood transfusions if a patient's life is at risk, however much family members disagree. This is even more crucial when the patients in question cannot speak for themselves, and experts must decide on their behalf.

In the case of the Siamese pair, a large number of experts agree. Leading paediatricians from Great Ormond Street, London, support the specialists at St Mary's Hospital, Manchester. In their collective judgement, without separation the twins have very little chance of surviving beyond six months; with separation, one of them could go on into adulthood. Surely a team of top neo-natal consultants and a court ruling score higher in the decision- making stakes than two Catholic (superstitious) parents from a remote south European (backward) community?

But it is less than obvious who the experts are in a case like this. For the parents' reluctance to agree to the operation is not based on ignorance of the medical facts. Nor is their refusal to consent based on any objection to hospital treatment, drugs, operations, anaesthetic, blood transfusions or any of the many benefits of medical science in themselves.

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Faith & Reason: The Siamese Dilemma: Science vs Superstition? ; the Medical Facts May Look Cut and Dried. but Sacrificing the Weak for the Strong Is the Ethic Which Lies Behind Social Darwinism and Fascism
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