Topic awaiting preservation: The Choice of Twins... (Page 1 of 1)

There has been a story in the news recently about Iranian twin sisters Ladan and Laleh Bijani who were conjoined at the head. After living this way for 29 years, they made a decision to go through surgery to be separated. Despite discouragement from surgeons and physicians because the risk of death was so high, they chose to go ahead with the surgery. Sadly, it was not successful.

This New York Times Article is bringing to light voices saying this surgery was unethical.

The twins were given full knowledge of the risks associated with the surgery. They understood that they had a 50% chance of dying. These were not people that were mentally impaired in any way. The ethical question being presented is this: Given this was an elective surgery, were the surgeons right in proceeding when there was such a high risk of death? The arguments are that because the women were in good physical condition and were functioning phyisologically well, the surgery was not medically necessary. One doctor in the article is quoted as saying, "...not to save lives but primarily to meet the psychological needs of the twins."

I have a hard time seeing the ethical problem here. Apparantly it would have been fine for these women to suffer the rest of their lives in psychological anguish. No one will ever know if one or both would have ventured down the path of mental illness, but given the fact that they decided that even the risk of death was better than continuing on as they had- I don't know how far off it would have been.

According to this same article, this type of surgery carries the same risk of death to one or both twins even in infants and children- 50 percent. Of the surgeries performed to separate infants and children joined at the head, I have no data about how many of them are medically necessary. I would be willing to bet that not all of them are however... Parents make the choice that given the risks, they want to provide a better quality of life for their children- and elect for the very same surgery. But I haven't heard yet of an ethical problem doing this type of surgery on infants.

So what makes these women so different that it has raised an "ethical" question? Is it because they were adults that knew they could die and chose the risk rather than "sucking it up" and suffering the rest of their lives? Perhaps there is a fine line that I am not seeing- some line that shouldn't be crossed. I don't see this procedure as setting any sort of unwanted precedent. What I do see is hope for other adult conjoined twins that they may one day live separate lives. I am sure that these women did not die in vain- through their courageous choice, the risk may not be so great in the future.

I see no ethical problem here.

Here's an idea: attach someone to this guy's head for 30 years, and then see what he thinks of the surgery.

=)

Also given that the chance of dying from alot of other surgical prceedures is just as high, if not higher, and they are always perfromed with the consent of the patient. Coranary bypass surgery is extremley dangerous, yet it is performed on a daily basis...

I'm not seeing the ethical issue here either.

Yep. Complicated surgery or not, the twins made the decision to follow through with the surgery. If you ask me the surgeons are merely providing a service allowing the twins the means to act on a decision that has had plenty of thought poured into it (on those same lines, I see no harm in euthanasia), and as such, shouldn't be responsible for the twins' decisions.

2¢

I think it would have been unethical to deny the chance to live a normal life.

50/50 ODDS for survival ? I would take that chance in a split second !

I am questioning Dr. Siegels ethnics - and his credibilty as a physician.

This makes interesting reading.
[url=http://www.ama-assn.org/apps/pf_online/pf_online?f_n=browse&doc=policyfiles/CEJA/E-2.17.HTM&&s_t=&st_p=&nth=1&prev_pol=policyfiles/CEJA/E-1.02.HTM&nxt_pol=policyfiles/CEJA/E-2 .01.HTM&] Quality of life as per the American Medical Association[/url]

What quality of life is it if you cann't not perform the most basic things on your own, your whole life is based on continous co-operation of another human and on it goes.


sib

edit: Was trying to fix the link
edit: Odds to get this link to work are slim for me

[This message has been edited by sib (edited 07-17-2003).]

[This message has been edited by sib (edited 07-17-2003).]

Edit: Interesting, the Asylum likes to make that link break for some reason? It inserts spaces.. Anyway, here. Removed some of the jargon from the URL, works fine.

http://www.ama-assn.org/apps/pf_online/pf_online?f_n=browse&doc=po licyfiles/CEJA/E-2.17.HTM&s_t=&st_p=&nth=1

[This message has been edited by Raptor (edited 07-17-2003).]