A modern Solomon's baby?

A story reported last week from outside London seems to require the judgment of a modern-day Solomon. A couple from an unidentified eastern European country came to England for the birth of their children, conjoined twins joined at the hip and sharing most of their major internal organs. The parents sought hi-tech medical care unavailable to them at home, but after hearing what specialists had to offer, decided to forego any medical treatment for their newborn daughters. Should parents always be permitted to make medical judgments on behalf of their children, even if it means their death? What is the role of the medical profession and the state in imposing their judgment over that of parents -- especially when parents make well-reasoned, but unpopular choices? When should the perceived interests of children override the strongly held beliefs of their parents?

What's your opinion?

Killing one child to save another

What makes this case so compelling is that it poses a problem that is almost impossible to solve. Because of the nature of their physiology, the twins cannot survive long connected to each other, since they share a single heart, lungs, and most of the other major internal organs. Since both twins cannot survive, the consulting medical specialists recommended separating the twins, with the knowledge that saving one will kill the other. The parents have refused to choose any treatment that will kill one of their children, and have suggested that the fate of the twins is in God's hands.

Under other circumstances we would never suggest that the life of one person should be sacrificed to save the life of another. We don't allow parents to donate their hearts to save their children's lives, and recently a man's offer to donate his second and only remaining kidney to his daughter was rejected. The principle we rely on in both cases is that it is wrong to trade the life or health of one person to benefit another. But when the two people involved share what amounts to a single body, no one would argue with the parents' decision to do their best to save at least one of the children.

Whose decision is it anyway?

Rather than face a version of Sophie's Choice, the parents in this case decided not to choose between the twins. The British hospital is considering taking action to compel separation of the twins so that the life of at least one can be saved. But the parents are clear that their religious convictions prevent them from endorsing such a course of action, effectively pitting their beliefs against the experts' medical judgment. Of course even if their beliefs were unorthodox but supported a decision that was consistent with medical judgment, there would be no controversy. It is partly a function of western medicine's presumption to treat (and cure) that makes decisions to forego treatment difficult to accept. When the health and life of children are involved, it is even more difficult to stand by when there is some treatment to be offered.

But until we can be sure that public officials have access to the wisdom of Solomon, we should be very wary of the state imposing its view of the best treatment of children. No one should have to decide to divide a baby in two. But when a case arises, we should presume that parents know best, since intrusion in such private decisions can quickly become public policy at its worst.