Perhaps you've read (or seen) Sophie's Choice, the story of a Jewish concentration camp survivor who relives the terrible choice she was forced to make during her internment. Recently the English legal system has been witness to a similar contemporary tragedy, brought to bear on a legal dilemma that would surely test the wisdom of Solomon. Two parents from the island of Gozo, near Malta, came to Britain when they discovered that the twins daughters in the mother's uterus were conjoined at the lower abdomen - sometimes referred to as Siamese twins. However, on birth, one of the twins, Mary, had cardiac, respiratory and brain function very poorly developed, whilst her sister Jodie appeared to be a vibrant and physiologically healthy infant. It is a terrible twist to this scenario that Mary is dependent for her oxygen and blood on her healthy sister, but unless separated they will both die within 3-6 months. Mary cannot function on her own. The treating doctors believed that Mary must be sacrificed in order to ensure the survival of Jodie. Their best bet is that there is a 65% chance that Jodie will survive a separation, though she will have some significant disability. And that is likely to be after 5 years in a British hospital and innumerable operations. The parents, both devout Catholics, believe nature should be allowed to take its course. Hence the matter has found its way into the English Courts. The issuesThis is no place for right or wrong - perhaps it is better for those of us who are parents to merely thank Providence that we are not in the place of the parents. Anti-euthanasia proponents have loudly protested that the more disabled of the twins should not be sacrificed to save the viable twin. The Catholic Archbishop of Westminster has voiced a concern that a precedent might be set in English law that would allow a living person to be killed to prolong the life of another. And of course, there are the usual troops of bioethicists, scientists, moralists and academics - take your choice here: the rights of parents should be paramount; the rights of the child is paramount; the State should (or shouldn't) intervene; the best interests of one child should (or should not) prevail over another; there is never a reason to justify intentional death (and endless other opinion). Pity the poor judges. When the dispute reached the Court of Appeal the judges, reluctantly, made a determination that Mary would have to be sacrificed. Let's look at some of their thoughts: "The surgery would be plainly be in Jodie's best interests, and in my judgement it would be in the best interests of Mary also." (Lord Justice Walker) "Though Mary has a right to life, she has little right to be alive. She is alive because, and only because, she sucks the lifeblood out of Jodie." (Lord Justice Ward) "…finally, the doctrine of the sanctity of life respects the integrity of the human body." (Lord Justice Brooke)d or de facto couples. It's a fair question - what has the law got to do with this family's tragedy? Surely it is the right of any parent to make a choice in a situation like this? You may be surprised to know that this would usually be the case in Australia as well as England. Parents generally have the legal control of their children, and can both consent to and refuse medical treatment on their behalf. For the surgeons to carry out the proposed separation of the twins they would have to physically touch Mary's body - in legal terms this would amount to an assault. She cannot consent, so that is legally left to the parents. Since they have refused permission, only a Court can intervene to overrule the parents' refusal. The situation would be the same in Australia, where the Courts can intercede on the basis that the welfare of a child is always paramount - the Court is the final guardian of a child's best interests. That's the law. But is it right that the Courts should have this right to intervene in all situations? It is the parents who will truly bear the judgement of the Court, not the Court itself, and surely not the media and religious sympathisers so quick to volunteer their convictions to the world. It is surely disturbing, and an irony, that traumatic decisions may be taken out of the hands of the parents because they are too emotionally close to the situation - and yet, in all cases, we want parents to be emotionally close to their children. David Harris QC, on behalf of the Official Solicitor (who represents those unable to represent themselves) pleaded for Mary's life. But Lord Justice Ward summed up the dilemma in this way: "Your client's position is not only anomalous but produces a kind of fallacy. You invite us to treat her as a single individual life, when everybody knows that had she been born a single person she would have been left to die. Now she survives because she is unnaturally hooked into her sister, draining her sister's life blood from her. That, in the end, is going to kill her sister." It may also seem anomalous that a Court could order an operation that would effectively lead to the intentional cessation of a life. This was addressed by Lord Justice Ward, who suggested that it might be God's will for Mary to die. "It was not God's will that this baby should live because it wasn't born with the capacity to live and death is inevitable. This child wasn't naturally capable of life and would die. Nobody in their right mind would hook this child to a life-support system, given the utter deformity of her heart and lungs. You would let her die." In the end it came down to a choice between the scalpel and the "will of God". The Court of Appeal judges refused to stop an operation to separate the twins, even though it was clear that it would lead to the certain death of Mary. "She sucks the lifeblood of Jodie, and her parasitic living will soon be the cause of Jodie ceasing to live," said Lord Justice Ward. "Jodie is entitled to protest that Mary is killing her. Mary, sadly, is beyond any help. The sad fact is that she lives on borrowed time, all of it borrowed from her sister. She is incapable of independent living. She is designated for death." It is clear that in these terrible circumstances the Court has not sought to value the life of one twin against the other - although it may appear to be splitting hairs, the only reasonable recourse was to balance the welfare of one child against the other. The Court looked at the actual condition of the children as they are and assessed their legitimate expectations when determining whether it is worth treating them. Clearly Mary was never going to have a sustainable existence, and unless separated Jodie would follow her to death. This was never a case for doctors, who are under a legal duty to do no harm to either twin. It is an important lesson in the limits of the law - there can never be an appropriate response to a case that enmeshes complex legal, moral and ethical issues. The Court's decision will not be appealed to the House of Lords, as the parents or Mary's representative are entitled to do. Whatever the outcome, as in many legal dilemmas, there will not be winners or losers, just a verdict. Read this: The legal information contained above is intended to be general information about the law. It is not a substitute for legal and other professional advice. 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