Saturday, July 26, 2003

The death of the twins…. On what side of the River Styx are the ethics of death to be found?

When the twins, Ladan and Laleh Bijani, died chancing an operation to separate them (they had lived 29 years joined at the head) controversy emerged from the grief and centered on the ethical dilemmas of the procedure itself.

It was sad, yes. But ethically wrong? Who has the right to chose life for another? Who has the right to define quality of life? When the ethicist said: “For an operation that was not medically necessary, a 50 percent risk of death was too high. Such high risks are acceptable when a patients is likely to die without surgery, and the surgery, though dangerous, offers at least a chance of saving the patient's life”, upon what does he presume that this wasn’t about saving two lives? Are we truly ethical creatures if our so called ethics can't extend beyond these notions?

These women, well educated, highly intelligent, very aware and active in their world around them, were perhaps the only ones who could understand why this operation needed to be done. They had reached a stage in their life where they would rather take the chance of death then have to continue in the manner with which they were made to. Essentially for them their lives had ended, as they couldn’t proceed any further together. They couldn’t get married, have a family, pursue separate careers, or even discover who they were apart from each other. They had never been able to even look each other in the eye.

I think that this operation was about saving the patients lives. Perhaps the operation itself could have been approached in a different way by surgeons - and it is unfortunate that it didn’t result in a successful separation, but I wouldn’t go so far as to say that the (almost inevitable) outcome wasn’t a considered and maybe even a welcomed outcome by the two, in comparison both to the life they lived and for the prospective chance that it offered them.

Let them rest in peace. Al-Fateha!

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