Skip to main content
Log in

Ethics and conjoined twins

  • Special Annual Issue
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Introduction

The birth of live conjoined twins in a community can draw considerable attention to the appropriate ethical issues.

Discussion

The management requires the skills of a multi-disciplinary team of clinicians who have seldom faced the challenge. The team leader must draw together principles of a medical, social, cultural, religious and legal nature in reaching the best outcome. Often the basic question is whether one child should die or both? At times the question is raised whether it is justifiable to sacrifice one life to save the other. In these days of high technology, surgeons can be tempted to go a bridge too far. In reaching this decision there can be numerous hidden conflicts of interest. Increasingly the final decision needs to be made and approved by the courts so as to protect the rights of the twins and to ensure surgical intervention is not an unlawful act.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Barilan YM (2002) Head counting vs heart counting. An examination of the recent case of the conjoined twins from Malta. Perspect Biol Med 45:593–605

    PubMed  Google Scholar 

  2. Barilan YM (2003) One or two: an examination of the recent case of the conjoined twins from Malta. J Med Philos 28:27–44

    Article  PubMed  Google Scholar 

  3. Bondeson J (1992) The Biddenden maids, a curious chapter in the history of conjoined twins. J R Soc Med 85:217–221

    CAS  PubMed  Google Scholar 

  4. Campbell N (2000) The impaired fetus and the newborn. In: Dooley B, Fearnside M, Gorton M (eds) Surgery, ethics and the law. Blackwell Asia, Melbourne, pp 41–52

  5. Drake D (1977) One must die so the other may live. Nurs Forum 16:229–249

    Google Scholar 

  6. Harper RG et al (1980) Xiphopagus conjoined twins. A 300 year review of the obstetric morphopathologic, neonatal and surgical parameters. Am J Obstet Gynecol 131:617–629

    Google Scholar 

  7. Lakoff G, Johnson M (1999) Philosophy in the flesh. Basic Books, New York

  8. Little JBE (1986) Congenital anomalies in twins. Semin Perinat 10:50–64

    CAS  Google Scholar 

  9. London AJ, Knowles LP (2001) The Maltese conjoined twins—two views of their separation. The Hastings Center Report 31 (Jan–Feb):48–52

  10. Mallia P (2002) The case of the Maltese Siamese twins—when moral arguments balance out should parental rights come into play. Med Health Care Philos 5:205–209

    Article  PubMed  Google Scholar 

  11. Pepper CK (1967) Ethical and moral considerations in the separation of conjoined twins. Birth Defects 3:128–134

    Google Scholar 

  12. Raffensperger J (1997) A philosophical approach to conjoined twins. Pediatr Surg Int 12:249–255

    Article  CAS  PubMed  Google Scholar 

  13. Ramsay S (2000) Landmark ruling on Siamese twins in UK. Lancet 356:838

    Article  PubMed  Google Scholar 

  14. Robertson A (1952) Chang–Eng’s American heritage. Life (August):70

  15. Rorty AO (1976) The identities of persons. University of California, Berkley

  16. Sheldon S, Wilkinson S (1997) The legality and ethics of sacrifice. Med Law Rev 5:149–171

    PubMed  Google Scholar 

  17. Smith JD (1988) Psychological profiles of conjoined twins. Praeger, Westport, CT, p 147

  18. Stahl Rabbi SM (2000) Separating conjoined twins: an ethical dilemma. Sermon given Dec 1 2000

    Google Scholar 

  19. Sulmasy DP (2000) Heart and soul: the case of the conjoined twins. J Am 183:12–14

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Leigh Atkinson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Atkinson, L. Ethics and conjoined twins. Childs Nerv Syst 20, 504–507 (2004). https://doi.org/10.1007/s00381-004-0983-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-004-0983-6

Keywords

Navigation