''Re A (conjoined twins)''

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2 WLR 480 is a

Court of Appeal A court of appeals, also called a court of appeal, appellate court, appeal court, court of second instance or second instance court, is any court of law that is empowered to hear an appeal of a trial court or other lower tribunal. In much of t ...

decision on the separation of conjoined twins. The case raised legal and ethical dilemmas. It was ruled it would be permissible to sever and thus kill in a palliative, sympathetic manner the weaker to save the much stronger. The case was among those where it would be lawful to act—conduct surgery—against the wishes of the parents. The prevailing orthodoxy within a faith, even that of the parents, was held not to be overriding, nor general applicability of the outcome to all such cases.

Facts

Rosie and Gracie Attard, who were born on 8 August 2000, were conjoined twins who were joined at the abdomen. During legal deliberations, they were given the public pseudonyms "Mary" and "Jodie", respectively. The medical evidence proved Gracie as stronger sibling, sustaining the life of Rosie; Rosie had survived birth due to a shared common artery supplied by Gracie. If surgically separated, Gracie had a 94% survival rate with little margin of error, but Rosie was guaranteed to die. If left conjoined, then their life expectancy—fast deteriorating—would be, with low margin of error, six months.

Reasons of judgment and appeal decision

At first instance, Justice Johnson was left to decide the case without any direct precedents to bind nor guide him. The law requires reasoning by analogy (abstraction) of precedent case law. He chose primarily ''

Airedale NHS Trust v Bland Anthony David Bland (21 September 1970 – 3 March 1993) was a supporter of Liverpool F.C. injured in the Hillsborough disaster. He suffered severe brain damage that left him in a persistent vegetative state as a consequence of which the hospita ...

'' where it was declared acceptable to remove life support. He ruled separation would not be

murder Murder is the unlawful killing of another human without justification (jurisprudence), justification or valid excuse (legal), excuse, especially the unlawful killing of another human with malice aforethought. ("The killing of another person wit ...

but a case of "passive

euthanasia Euthanasia (from el, εὐθανασία 'good death': εὖ, ''eu'' 'well, good' + θάνατος, ''thanatos'' 'death') is the practice of intentionally ending life to eliminate pain and suffering. Different countries have different eut ...

" in which food and hydration would be withdrawn. The Court of Appeal agreed in outcome but rejected this analysis. The three appellate judges gave contrasting legal reasoning. Lord Justice Alan Ward invoked the concept of self-defence suggesting that "If raciecould speak she would surely protest, ''Stop it,

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you're killing me.''" Lord Justice Brooke relied upon '' R v Dudley and Stephens'' and invoked

necessity Necessary or necessity may refer to: * Need ** An action somebody may feel they must do ** An important task or essential thing to do at a particular time or by a particular moment * Necessary and sufficient condition, in logic, something that is ...

as a defence. Lord Justice Robert Walker focused upon the morally understandable intention of the surgeons, and the great body of profession opinion, in concluding that surgery could go ahead.

Result

The 20-hour-long operation to separate the twins took place on 7 November 2000.{{Cite news , url=https://www.timesofmalta.com/articles/view/20141011/local/gozos-miracle-twin-gracie-attard-tells-her-story.539262 , title=Gozo's miracle twin Gracie Attard tells her story , date=11 October 2014 , work=Times of Malta , access-date=2017-07-05 , language=en-GB As expected, Gracie survived the operation and Rosie died. Rosie's remains were later buried on the

Maltese Maltese may refer to: * Someone or something of, from, or related to Malta * Maltese alphabet * Maltese cuisine * Maltese culture * Maltese language, the Semitic language spoken by Maltese people * Maltese people, people from Malta or of Malte ...

island of

Gozo Gozo (, ), Maltese: ''Għawdex'' () and in antiquity known as Gaulos ( xpu, 𐤂𐤅𐤋, ; grc, Γαῦλος, Gaúlos), is an island in the Maltese archipelago in the Mediterranean Sea. The island is part of the Republic of Malta. After t ...

. In 2014, when Gracie was 14 years old, she was living a reasonably normal life, had a younger sister, and was thinking about studying to become a physician.

References

External links

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Court of Appeal judgment
English criminal case law Conjoined twins Court of Appeal (England and Wales) cases Medical law Medical controversies in the United Kingdom 2000 in case law 2000 in British law English tort case law

Facts

Reasons of judgment and appeal decision

Result

See also

References

External links