Theo Todman's Web Page - Paper Abstracts

Author’s Introduction

1. The case of the conjoined twins, Mary and Jodie, attracted worldwide publicity during September 2000. But memories fade quickly, and I should perhaps begin by reminding you of the basic facts. Then I want to devote most of my time to discussing the very unusual and difficult legal issues which the case raised. I want to concentrate especially on the impact of these issues on the surgeons, doctors and nurses who had the responsibility for caring for the twins. I want to talk primarily about legal principles, not about ethical or religious issues, but it is of course impossible, in a case of this sort, to keep them completely separate.
2. The twins were born on 8 August 2000. Mary and Jodie are not their real names but those are the names by which they became known to the world, and I will use those names, although most of the injunctions intended to secure the family’s privacy have now been lifted. (I will come back to the injunctions later on.)
3. As is now well known, the twins’ parents lived in Gozo, a small island near Malta. It is notable for the strong Roman Catholic faith of its inhabitants and the relatively poor state of its economy. The father had been unemployed, through no fault of his own, for eight years. The mother had had a low-paid job. They had been married for two years and this was her first pregnancy.
4. When the mother was about four months pregnant an ultrasound scan disclosed that she was carrying conjoined twins. A local doctor who had trained at St Mary’s Hospital, Manchester advised that she should be referred there, and that was achieved under a long-standing financial arrangement between Malta and the United Kingdom. She travelled to Manchester in May 2000 and had numerous scans and investigations at Manchester and Sheffield. From these it became apparent that one of the twins was in a poor condition and might not survive birth.
5. The doctors who were caring for the mother discussed the situation fully with her and her husband. They at once recognised that the parents’ religious beliefs not only excluded any consideration of termination of pregnancy, but also required the management of the birth to be as non-interventionist as possible.