Dilemma
Read this case study and answer the questions based on your readings:
A couple from Edmonton traveled to Calgary for a complicated delivery of their Siamese twin daughters. Emma and Sophia were born on August 8, 2009, with a fused spine. Doctors soon determined that unless the twins were surgically separated, both would die.
Emma, the weaker twin, whose brain was underdeveloped, would never be able to survive separated from Sophia. Sophia, who was strong and alert, had an 75-95% chance of dying if surgery was not performed. She had a good chance of surviving in the event of surgery although, in all likelihood, she would be severely handicapped and need medical attention throughout her life.
In similar cases in the past, the surviving twin has sometimes died within six months of surgery. In other cases, neither twin survives. The medical team at the Alberta Children’s Hospital, to which the twins were taken, had never done a successful separation of Siamese twins.
When the medical team suggested surgical separation, the parents, who were Roman Catholic, refused on religious and moral grounds to give their consent. The hospital went to court, pleading that life-saving surgery was in Sophia’s best interest and that saving one of the twins would be morally preferable to losing both.
The presiding judge acknowledged the court’s duty “to put the welfare of each child paramount” but, nonetheless, concluded that Sophia’s right to life outweighed Emma’s, thus ruling in favour of the hospital.
Questions
1. Imagine you are head of pediatric surgery at the hospital, and you intend to recommend to the parents that Emma and Sophia be surgically separated. Choose one moral theory and use it to outline your argument that the best choice is surgical separation.
2. Imagine you are Emma’s and Sophia’s parents. Explain to the surgeon why you are not willing to consent to an operation to separate the twins. Here, explain, based on your readings of Chapter 14 of Ashcroft, R.E., Dawson, A., Draper, H., & McMillan, J.R. (2007). Principles of Health Care Ethics. John Wiley and Sons, Ltd.
3. If you were a neo-natal intensive care nurse caring for Emma and Sophia, what course of action would you support? Choose a moral theory and use it to support your views at the health care team meeting which is likely to be called.
4. Finally, imagine the hospital consults its clinical ethicist for assistance. She uses the principles of health care ethics to facilitate further discussion with the health care providers and the parents. What will she say?