- The Washington Times - Tuesday, September 12, 2000

Siamese twin girls in Great Britain born last Aug. 8 are destined to die within months absent separation surgery that will save one but cause the instant death of the other. One of the daughters, known as "Jodie" in court records, sports a normal brain, heart and lungs. Jodie's impaired sister, known as "Mary," suffers from non-functioning lungs and heart. Mary lives only by utilizing Jodie's critical organs.
Doctors supporting the surgery are, at present, lined up in litigation before Britain's Court of Appeals against the Roman Catholic parents of Jodie and Mary and an attorney appointed to represent the fatally afflicted sister. The Court of Appeals should order the twins' separation. The legal and moral case for an operation to save Jodie and concurrently to confer virtual martyrdom on her tragically doomed sister seems exceptionally convincing.
Human life derives its grandeur from rising above simple survival in pursuit of higher moral causes, even at the risk or certainty of death. As Shakespeare deprecated in "Hamlet," "What is a man, If his chief good and market of his time be but to sleep and feed? A beast. No more."
To choose death over life may be morally electrifying. In "A Tale of Two Cities," we instinctively concur with Sydney Carton's celebration of his decision to substitute himself for Charles Darnay on the French Revolutionary guillotine: "It is a far, far better thing that I do, than I have ever done; it is a far, far better rest that I go to, than I have ever known."
A mother who refuses a life-saving operation during childbirth to save the fetus evokes universal admiration. Ditto for a soldier who throws himself before bullets to save his comrades. Nathan Hale's last words before his hanging by the British are legendary: "I regret that I have but one life to lose for my country."
In sum, whether a choice for death over life is praiseworthy and moral pivots on motivation. The case of the infant Siamese twins is complicated because Mary cannot be consulted as to whether she would prefer surgical separation to save sister Jodie over consigning both to certain death in a matter of months. But place yourself in Mary's shoes. Wouldn't she think it an outrageous slur to impute to her a mean-spirited preference for a few months of additional survival to a martyrdom that would permit sister Jodie to live a full life? Wouldn't Mary covet the ennoblement bestowed by the operation, and the everlasting gratitude of Jodie? Thus, doesn't the doctor recommended surgery promote the best interests of both sisters?
The well-intended opposition seems unpersuasive. The Roman Catholic parents in a written statement have protested: "We cannot begin to accept or to contemplate that one of our children should die to enable the other to survive. We have very strong feelings that neither of our children should receive any medical treatment… . We have faith in God and we are quite happy for God's will to decide what happens to our two daughters."
But the religious convictions of parents do not invariably trump the imputed but highly probable moral sensibilities or preferences of their children, at least when life and death are in stake. They may, for instance, be criminally prosecuted for religiously motivated withholdings of life-saving medical treatments. It might be speculated, nevertheless, that if Jodie is saved she may grow to embrace a creed morally offended by the surgery and in favor of a mutual infant death with Mary. Thus, her best interests might militate against saving her life now. That possibility is far from fatuous. Indeed, Jodie's parents would seem to hold that moral view. The law and morals, however, are informed by probabilities when certitude is chimerical, which is typically the case. And it seems far more likely that a mature Jodie will believe the superior way to consecrate Mary's death is through Good Samaritan works and memorials to her sister's abbreviated life.
As reported in The Washington Post, Archbishop of Westminster Cormac Murphy-O'Connor is preaching against life-saving surgery for Jodie: "There is a fundamental moral principle at stake. No one may commit a wrong action that good may come of it. The parents in this case have made clear that they love both their children equally, and cannot consent to one of them being killed to help the other. I believe this moral instinct is right."
But the preaching seems to beg the dispositive moral question: Whether Mary herself would be uplifted by sacrificial surgery to save Jodie by endowing the former's tragic and truncated life with a nobility that will live for the ages? Neither the archbishop nor the parents have stated anything against an affirmative answer.
Let the surgery proceed, but with the humility that human fallibility may nevertheless have occasioned an errant judgment.


Bruce Fein is a lawyer and free-lance writer specializing in legal issues.

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