ABSTRACT
The conjoined twins Jodie andMary were born in August 2000 toMichelangelo and Rina Attard who lived on the Maltese island of Gozo but had arrived at St Mary’s Hospital, Manchester, seeking medical assistance unavailable in their home country. Joined at the pelvis, the twins had mainly separate vital organs. Their circulatory system, however, was shared, being joined at the main artery through which Jodie’s heart supplied oxygenated blood to both babies. Critically, Mary’s heart and lungs did not work and her brain function was significantly impaired; indeed, had she been born a singleton she would not have survived birth and could not have been resuscitated. After examination by the doctors various options were established, with widely varying consequences: leaving the twins conjoined would result in the death of both; performing surgery to separate them would preserve Jodie’s life but prematurely end Mary’s; separating only in an emergency would diminish significantly the likelihood of a successful outcome for Jodie. Crucially, although both parents were keen to take advantage of the best medical assistance available they opposed surgery, arguing that they could not accept or contemplate that one of their children should die to enable the other one to survive. In many jurisdictions that would have been the end of the matter, and an
operation to separate the twins would never have taken place since the parents’ wishes would have prevailed. But the Manchester medical experts felt they could not simply stand by while both babies died; especially, since in their opinion they could certainly save one of them. So, unable to secure the necessary parental consent for the operation, the hospital applied to the High Court for a declaration that surgery to separate the twins would be lawful. In the High Court, with no legal precedent to guide and with very
little time available to form a carefully reasoned and researched judgement, Justice Johnson decided to allow the separation. Unhappy with this decision, the parents appealed; however, in the Appellate Court all their appeals were dismissed, each of the judges, though for vastly differing reasons, finding in favour of lawful separation. In November 2000, surgery to separate the conjoined twins, Jodie and Mary, was performed at St Mary’s Hospital, Manchester, England. As expected, Jodie survived, but Mary died.
