Fragile Lives, Tough Questions Surgery on Siamese Twins Illustrates Medical Ethics Dilemma

By Lou Chapman 1993, Fort Worth Star-Telegram | St Louis Post-Dispatch (MO), August 22, 1993 | Go to article overview

Fragile Lives, Tough Questions Surgery on Siamese Twins Illustrates Medical Ethics Dilemma


Lou Chapman 1993, Fort Worth Star-Telegram, St Louis Post-Dispatch (MO)


The surgery that ended the life of 7-week-old Amy Lakeberg so that her Siamese twin, Angela, might have a life raises questions about medical ethics and the burden that modern science places on physicians.

"If these babies had been born in rural Guatemala, there would be no decision to make," said Roy Martin, a medical ethicist and senior chaplain at Cook-Fort Worth Children's Medical Center in Fort Worth, Texas. "These babies would have been allowed to die."

But the advances of science and the routine decisions by specialized facilities to underwrite much of the expensive procedures they perform and follow-up care they provide force difficult considerations.

"Two things have collided in the history of Western civilization," Martin said. "With the advance of science, we almost have this terrible compulsion that says, `If we can do something, we must do it. If we have the technology to do it, we should.' That's not always the right choice."

Doctors at Children's Hospital of Philadelphia said the heart that Amy and Angela Lakeberg shared could not keep both of them alive beyond another few weeks. With the approval of the twins' parents, surgeons sacrificed Amy to implant the twins' reconstructed heart into Angela.

The operation Friday was the hospital's fourth on joined twins with shared hearts; the longest survivor, separated in 1977, died of liver failure after three months.

Angela's chances at survival were placed before the surgery at about 1 percent. Such a remote chance for survival plays a role in the ethical debate, one ethicist said. …

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