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Twins Conjoined At Birth Only One Can Survive: Re A Case Analysis



Gracie and Rosie, conjoined twins at birth presented their parents with a tough decision, they were to either separate them and have one of them survive, or leave them conjoined and have them both not live past their first birthday. Rosie was reliant on Gracie to be able to oxygenate her blood through a common artery, however, if they were to be separated Gracie had a 94% chance of survival but Rosie would die as she was dependent on Gracie for oxygen.


After the birth of the twins the doctors believed it was best to separate them, however, after finding this out about their twins, the parents went against the doctor’s decision and revoked consent to separate the twins, keeping the girls conjoined. The doctors filled for a court declaration for the right to surgically separate the children as it would be the most lawful and in the best interest of the children. During the case, the twins were assigned the names, Jodie and Mary.


Justice Johnson, the Judge in the case deliberated on the case initially based on no precedent whatsoever as there was no previous case like it, he was not able to look at previous cases to help him decide on what to do. However, the law requires that for there to be a ruling on a case there must be a previous precedent of a previous case in the past.


Because of this law, Justice Johnson chose Airedale NHS Trust v Bland as his case for precedent. The case was about a patient who was no capable of deciding whether or not to consent to a specific treatment. This was because according to the law “Medical treatment, including artificial feeding and the administration of antibiotic drugs, could lawfully be withheld from an insensate patient with no hope of recovery when it was known that the result would be that the patient would shortly thereafter die, provided responsible and competent medical opinion was of the view that it would be in the patient’s best interests not to prolong his life by continuing that form of medical treatment because such continuance was futile and would not confer any benefit on him.” As well as if that life support is discontinued, either through the stopping of artificial feeding or any other act is not a criminal offense as it is considered to be in the patient’s best interest therefore the doctor is no longer required to give the patient that treatment. In summary, Justice Johnson chose this case as its final ruling was that it is legal to discontinue life support.



Using this precedent, Justice Johnson ruled that the separation of the twins would not be considered an act of murder and not be illegal as it would be a form of “‘passive euthanasia’ in which food and hydration would be withdrawn.”


Unsatisfied with the result of Justice Johnson’s ruling, Gracie and Rosie’s parents filed to the appellate court. Unfortunately for them, the court of appeals agreed with the outcome of the case but did not agree with the reasoning behind it and the precedent. The three lord justices presented 3 different but important pieces of evidence that helped them reach their final decision. The first Lord, ‘Lord Justice Alan Ward, invoked the concept of self-defense suggesting that "If [Gracie] could speak she would surely protest, Stop it, [Rosie], you're killing me.’” However, Lord Justice Brooke relied upon R v Dudley and Stephens to set precedent on the case. R v Dudley and Stephens case was about two sailors who were charged with murder for killing and eating their fellow sail mate as a way to survive, however, the ruling was that they were charged with murder as it was not w necessary to eat their sail mate. Lord Justice Brooke however deemed that in the case of Gracie and Rosie it was a necessity and could be used as a defense. Finally, “Lord Justice Robert Walker focused upon the morally understandable intention of the surgeons, and the great body of professional opinion, in concluding that surgery could go ahead”


The final ruling was that the surgery to separate the twins was going to happen, and on the 7th of November 2000, the 20-hour operation took place. Gracie survived and Rosie, unfortunately, passed away due to lack of oxygen in her bloodstream.


Cases like these show a large issue that the law may now address from time to time, that being the gap between what is right to do and what is legal to do. However, as time evolves and cases come to light and set precedent, there are more ethical grounds laid out to help set the path for the future. Thus as we evolve so does the law and the cases and ethical guidelines around it.



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