At Law: Siamese Twins: Killing One to Save the Other

Abstract

The birth of Siamese twins joined at the chest (thoracopagus twins)\nand sharing a heart creates an ethical dilemma. Infants with conjoined hearts\nsurvive no more than a few months, and physicians must decide whether to give\none child a chance at life by separating the twins and sacrificing one to give\nthe other an intact heart. Annas reviews the ethical and legal discussions\ngenerated by the birth and treatment of thoracopagus twins at Philadelphia's\nChildren's Hospital in 1977 and 1987. He considers most of the analogies used\nto justify the death of one twin to be strained. The situation becomes more\ncomplicated when there is no medical indication as to which twin has a better\nchance of surviving. Nevertheless, Annas concludes that the bleakness of the\ntwins' prognosis if they remain joined justifies separation and the death of\none child, despite the difficulty of developing a rationale for the act. (KIE\nabstract)