Academic journal article Denver Journal of International Law and Policy

Conjoined Twins: The Conflict between Parents and the Courts over the Medical Treatment of Children

Academic journal article Denver Journal of International Law and Policy

Conjoined Twins: The Conflict between Parents and the Courts over the Medical Treatment of Children

Article excerpt


The anomaly of conjoined twins fascinates and amazes people around the world. Conjoined twins are the subject of television documentaries and a source of curiosity and amazement. (1) With advances in medical treatment more conjoined twins survive birth. (2) Parents of conjoined twins immediately face life and death decisions concerning theft new babies. The most difficult of these decisions is whether or not to separate the twins. Medically, legally, and ethically the occurrence and survival of conjoined twins is an interesting and controversial topic. As Nancy Segal, an expert on twins and twinning, stated "[p]ublic debates on the physical and psychological treatment of conjoined twins have engaged physicians, families and reporters in triadic tangles over pregnancy termination, surgical separation, and postoperative management." (3)

In August of 2000, the first legal case involving the surgical separation of conjoined twins arrived in a British courtroom. (4) The case involved a fundamental dispute about medical care and the separation of conjoined twins which divided the scientific, legal and religious sectors of society. (5) The doctors believed the twins should be separated giving the stronger, viable twin an opportunity to live. The devoutly religious parents believed that the decision regarding whether the children lived or died should be left in God's hands. In their view no one should intentionally cause the death of another person." (6)

This comment explores how the courts in the United States might review a conjoined twins case such as the one of Jodie and Mary. As a starting point, this comment closely examines the facts and the judicial treatment by the Appeals Court in Britain of Jodie and Mary's case. This analysis examines the opinions of each Justice on the Court of Appeals as well as the Court's decision. The second part analyzes how courts in the United States treat medical cases where children either receive extraordinary medical treatment over the advice of their doctor. This comment explores the well known case of Baby K, a baby born without brain function in October, 1992. (7) This includes the judicial treatment by the trial court, as well as the court of appeals. Lastly, this comment address cases where parents refuse medical treatment for their minor children because of their religious beliefs.

This comment analyzes both the differences and the similarities in cases where medical treatment is sought to save life and cases in which parents refuse medical treatment on religious grounds. In addition to the case analysis, this comment contemplates the effect of parent's constitutional rights under the free exercise clause, the rights of children in terms of child abuse and neglect, the parent's rights in terms of child abuse and neglect, as well as the state's right to intervene.


Jodie and Mary were born on August 8, 2000. (8) The children were born to Michaelangelo and Rina Attard, devout Roman Catholics. (9) Jodie and Mary were ischiopagus tetrapus conjoined twins, (10) Thus, each had their own arms and legs, although they were joined at the pelvis and shared a linked spine. (11) The girls had their own internal organs, except for a shared bladder. (12) Jodie's heart and lungs performed all of the circulatory functions for both girls. (13) A common, shared artery enabled Jodie to circulate oxygenated blood for both of them. (14) The strain of supporting both girls would result in the death of both twins within a matter of weeks. (15) As the stronger twin, Jodie could survive on her own if separated from Mary but Mary would certainly die. (16)

The parents believed that God, not doctors, should decide whether their daughters lived or died. (17) The parents declined St. Mary's Hospital's offer to perform the operation to separate the girls.(18) In their eyes, the twins were equal in the eyes of their parents, so they would not sacrifice one to save the other. …

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