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Separating conjoined twins.

By rabbitfoot in Culture
Mon Aug 01, 2005 at 08:28:27 PM EST
Tags: Science (all tags)

Every so often a case comes before the courts which raises mind-blowing moral and legal issues. One such case was that of Mary and Jodie, conjoined twins born to a Maltese woman in August 2000. Five years on it raises debate amongst the medical profession. The Court of Appeal ruled that it was lawful for an operation to take place to separate the conjoined twins, even though the descision meant that one child, who had no heart or lungs, would die.

Discussions of medical ethics suggests that people should be allowed autonomy and that respecting a person's autonomy means that you respect the descisions they make for themselves. Autonomy has to do with people deciding what they wish to do on the basis of their own views and feelings. Obviously these children were too young to be given autonomy in their own right and do not fall into the framework that constitute Gillick Competency. Their parents were to act, therefore, as their advocate. The medical profession have a duty of beneficence to their patients, that meaning they have an obligation to always do their best for their patients. Consequently, they were left with little choice but to apply to the High Court for a declaration that it would be lawful to separate the twins when the parents refused to consent to the procedure.

During the pregnancy of the woman in Gozo, an island near Malta, it was realised that she would need facilities for the birth of her babies which were not available locally. Under a quota arrangement between the Maltese Health Authorities and the NHS, the mother went to Manchester, England, where the twins were born by caeserean section.

The bodies of the girls were fused together at the base of their spines, with their four legs splaying out sideways. They shared an aorta, the main vessel carrying blood away from the heart, and a bladder. Their circulatory sytems, muscles and skulls were joined together. The girl called Mary, had a primitive brain and her heart and lungs failed soon after birth. She was dependent, therefore on the heart and lungs of her sister Jodie, for survival.

The parents, both devout Catholics, had refused consent to any operation to separate them. The doctors, acting out their duty of beneficence, sought a declaration from the High Court to proceed with the separation. Medical evidence presented to the courts suggested that Jodie would have a reasonable chance of survival if the twins were to be separated, but such an operation would mean the death of Mary. If no operation were performed then it was likely that Jodie would not survive for long because of the strain placed upon her heart perfusing two bodies. Jodie's death would inevitably be followed by Mary's. The High Court judge issued a declaration that the operation should proceed. The parents appealed against this descision. The Court of Appeal asked for additional medical evidence, and also received a submission from the Archbishop of Westminster that the operation should not go ahead, but that the twins should be allowed to go to hospice at Ravenna in Italy and be treated there until they died. The case brought a storm of response from all sectors of the community and the Appeal Court was flooded with submissions supporting the rights of the parents. Groups supporting peoples equal rights to life were particulary vocal.

The issues before the Court of Appeal were:

Is it in Jodie's interests to be separated from Mary?

Is it in Mary's interests to be separatded from Jodie?

If there were a conflict between their individual interests, how can the court balance their interests of the one against the other?

If the interests of the one were in favour of the operation proceeding, could that be lawfully performed?

Is Mary a live person in her own right?

What weight should be given to the views of the parents?

Is it in Jodies interests to be separated from Mary?

There is no doubt on the facts that after the separation Jodie would have a reasonable chance of survival and lead a relatively normal life. In the eyes of the Court of Appeal, it was therefore overwhelmingly in Jodies best interests that she be given the chance to live a normal life with a normal expectation of life. It certainly was not in her interests to be left to die.

Is it in Mary's interests to be separated from Jodie?

There was no reliable way to test if Mary was in pain because she responded to pleasure and pain in the same way. It was not in her interests to undergo surgery as it would terminate her life.

If there were a conflict between their individual interests, how can the court balance the interests of one against the other?

Lord Justice Ward stated that:

"Since Mary has always been fated for an early death, her capacity to life has been fatally compromised. Though she has right to life, she has little right to be alive. She is alive because, and only because, she sucks the lifeblood of Jodie and her parasitic living will soon be the cause of Jodie ceasing to live. The best interests of the twins is to give the chance of life to the child whose actual bodily condition is capable of accepting the chance to her advantage, even if that has to be at the cost of the sacrifice of a life which is so unnaturally supported. I am therefore left in no doubt at all that the scales come down heavily in Jodies favour. The least detrimental choice is to permit separation to take place"

If the interests of the one were in favour of the operation proceeding, could that be lawfully performed?

The doctors had a duty of care to do what was best for their patient. Their duty to Jodie is to operate, but their duty to Mary is not to operate because it will kill her. The doctors had to balance these conflicts and were to reach the same conclusion as the courts. Since Mary is killing Jodie, then she can be killed in legitimate self-defence. The judge used the analogy of a 6-year-old boy indiscriminately shooting in a playground and then him being killed to prevent further harm.

Is Mary a live person in her own right?

Lord Justice Ward ruled that Mary is a living person in her own right.

What weight should be given to the views of the parents?

The parents would not consent to the surgery because of their devout religious beliefs. In their eyes it was God's will that they be born conjoined and should remain so for as long as God should ordain it. The judge stated that the wishes of the parents be treated with respect and not lightly set aside, but the personal hardship that they will suffer in raising Jodie cannot outweigh the right to life which she is entitled. In earlier decided cases, the welfare of the child is paramount and the parents wishes are secondary to the interests of the child.

Numerous counter submissions supporting the descisions of the court were made and many views expressed on the lawfulness of elective surgery to separate conjoined twins. Under article 2 of the European Convention on Human Rights it could be argued that Jodie's life was threatened and therefore it was lawful to take action to save her life, even if that meant the death of Mary.

The Court of Appeal judges declared that they knew that 50% of the population would disagree with their descision, but they could not abdicate responsibility. They could have made their descision easier by holding that Mary, because of her lack of independent living, was not a person and therefore no question of killing or murder arouse. However they recognised that Mary was a living person, but justified the killing of Mary on the grounds that it was self-defence for Jodie, who alone had the possibility of survival.

While there were strong opinions for and against the descision, in the long run it should not be taken as a precedent for permitting life to be taken. The distinction in law must be maintained between letting die and killing.

This case has long term ramifications, not just upon parental rights over their child's healthcare choice's, but also on what makes a human life and ultimatly if the rights to end that life can be given to third parties.

While the medical world were embroiled in the medico-socio legal ramblings of this case, Jodie and her parents' moved back to the island of Gozo, where they remain to this day.

Now known as Gracie Attard, this little girl, who is approaching her fifth birthday, forced a precedent in medical history that will not be quickly forgotten.


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Related Links
o Gillick Competency
o Groups supporting peoples equal rights to life
o on the lawfulness of elective surgery to separate conjoined twins.
o article 2 of the European Convention on Human Rights
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Separating conjoined twins. | 62 comments (44 topical, 18 editorial, 0 hidden)
The issue is hopefully a temporary one (2.87 / 8) (#2)
by jd on Sat Jul 30, 2005 at 02:48:39 PM EST

The key to the problem was that there weren't certain organs for the second child. Today's transplant technology is barely up to the task of giving double and triple transplants to adults - and they rarely survive long. It certainly isn't up to the task of doing the same for anyone that young.

However, technology improves and medical science improves. Sooner or later, the knowledge and skills required will exist. Very likely this will involve stem cell therapy - use stem cells to clone the shared organs, then connect the dependent child to the cloned organs. This will be safer than conventional transplants, as there would be next to zero chance of rejection, which is the number 1 risk.

However, none of this exists in any kind of meaningful way today. Stem cell research is limited (especially due to religious extremists in the US) and most medical research is by drug companies looking for the next big-selling product. Hey, you can't blame them for wanting to make money, but it doesn't really advance society a hell of a lot.

In today's world, there really is a major ethical dilema, because you have a major conflict of interest and no clear way to resolve it. The solution is always going to be the lesser of two evils, with a very unclear way of deciding which is in fact the lesser.

It MAY be possible to delay the issue - have an artificial heart in parallel to the regular one, to reduce the strain. Use dialasys to reduce the strain on the kidneys. And so on. This delays, rather than removes, the problem of having to decide what to do. However, it may also strengthen the organs enough (by eliminating the overload) to increase chances of survival by the primary twin - which would be no bad thing in itself.

It is possible to bypass the issue, to a degree. But only to a degree. And it wouldn't be cheap. This would involve separating shared-organ cojoined twins and then cryogenically preserving the one who lacked the vital organs until such time as the technology existed to repair the lack.

Unfortunately, this IS horribly expensive, cryogenics is still very poorly understood, and it is unclear as to whether the dependent twin would survive long enough after the operation to be able to safely be preserved before suffering permanent brain-death. (Cryogenics after death is completely pointless.) You also need enough lead-time to be able to use a water substitute for enough time to minimise cell damage from freezing - which may not be possible in such cases.

I posted a story about this on K5 a while back, in the case of cojoined twins where the second child was ONLY the head. The body never formed at all.

The ethical questions raised by such situations aren't trivial and aren't easy, but they ARE important to answer. In the US, the right-wingers like to talk of a right to life - but in this case, one child's right to life is another child's death, as technology stands, unless somehow medicare were boosted with defence-agency-like funding to support cryogenics. I can't see that happening any time soon.

The only resolution that respects right to life would involve enormous funding and research in stem cell work, and that's not going to happen because of those who argue that such work does not respect the right to life.

When there's a total impasse, the best anyone can do is pick the least-evil option and hope it really is the least evil.

+3 (1.50 / 2) (#4)
by alby on Sat Jul 30, 2005 at 02:53:47 PM EST

Right up until the part about cryogenics. Seems to me to be another case of a solution looking for a problem.

[ Parent ]

'We're going to freeze you until we find a cure (2.50 / 2) (#7)
by cburke on Sat Jul 30, 2005 at 04:32:02 PM EST

for being frozen in a meatlocker for however many years it takes.'

So you see, solution and problem are one and the same.  It's perfect!

[ Parent ]

I'd agree with you (2.00 / 2) (#10)
by jd on Sat Jul 30, 2005 at 07:41:51 PM EST

The problem is, at the current rate of progress (next to nil for stem cell research, because of US policies) absolutely any kind of stop-gap measure that can be taken to shorten the time of dilema would be useful.

The "correct" method is to get cloned organs so that both individuals can live. That is where we want to get to. At present, we have no idea how long it will take to get to that point - South Korea and Europe being the best hopes of this being possible, but they don't have the money or the facilities to get there quickly.

So what do we do in the meantime? The current situation, which is forced on us by medical necessity as we have no medical options, is ethically untennable for very long. We've got to bridge the gap between when we can no longer reasonably accept the current solution and when the correct solution will become available.

At present, there are no options that can be used, and only one (cryogenics) with enough research behind it to have a hope of being viable. And it is only a hope, as it is unproven to be reversible for any higher forms of life. But when there are only straws for you to grasp at, you might as well give it a go - a 0.0001% chance is still better than none at all.

Of course, if the US reversed its policy and started putting a few tens of billions into stem cell therapy, none of this would be necessary. There would be no gap, we'd have the ability to clone organs within a reasonable timeframe. However, the right-wing in the US is very powerful right now and the bills currently in Congress to even loosen the restrictions a little will be vetoed by the President. They haven't nearly enough votes to survive. In 2006, those who are willing to be moderate on this issue, in Republican-controlled areas, are likely to be replaced by people more acceptable to the far right.

(The Democrats, right now, are off in the wilderness and don't have the muscle to force the issue.)

If Europe and South Korea put enough funding in to make up the gap - and Europe is looking hard at their R&D budgets - then maybe, just maybe, there's a chance there. The problem is, South Korea is largely run by the Americans (indirectly, by the sheer military and economic muscle they have there) and the Americans resent the South Korean research bitterly. As for Europe, they're too divided right now to do a whole lot. The Iraq Adventure has caused deep rifts and re-opened old wounds, and the politics may make any kind of unity on stem-cell R&D impossible, no matter how ethically or medically necessary.

If the biggest hope is delayed, then someone has to buy the time to find a long-term solution, somehow. If you, or anyone else, can figure out a better way to buy that time, please do! The time is needed and the only stop-gap measure even remotely on the horizon is still unconfirmed as even being a possibility.

[ Parent ]

good comment but misleading (none / 1) (#40)
by SocratesGhost on Tue Aug 02, 2005 at 12:14:32 PM EST

Your comment reflects common misunderstandings about the current state of research for stem cells.

For one thing, I'm not convinced that stem cell research is the cure-all that people make it out to be. Most people think: if we do embryonic stem cell research, we will discover how to regenerate tissue, and develop therapies for Parkinsons, Alzheimers and cancer. For one thing, there are no guarantees. It's a promising field but we must remember it is research and not engineering and the money and lives we put in to it may not be worth the cost. It is a search and consequently we shouldn't shed all of our resources and human dignity simply because there's the possibility for gold at the end of the rainbow. A deliberative approach should always be preferred.

Also, the range of applications is almost universal. Almost every medical ailment claims some need for ESCR, even you do so here in the field of conjoined twins. It borders on the fantastical.

Similarly, the focus of the public's attention is on embryonic stem cells. Researchers claim that these provide the most promise and I won't argue with the researchers. However, if we are gaining results from research applied to adult stem cells, perhaps the need for embryonic research is overstated a bit.

So much for the state of the research side of things, let's look at the political misunderstandings. The current policy restricts the use of federal funds to existing lines. This means that the federal government does fund some amount of research, to the tune of $25 million in the year 2003. Non-embryonic research received $190 million more. It should be noted that new cell lines are not illegal and can receive private funding. As you've noted, private funding has been outpacing federal funding for years so the limits in place for federal research grants is substantially ameliorated. Also, unlike embryonic stem cell lines, there are no limits placed on adult stem cell research.

California has earmarked $3 billion (about $300 million per year) for state funded ESCR. Other states will likely follow to prevent a brain drain to the Golden State. Just for comparison's sake, the entire federal budget devoted to biomedical research is $20 billion.

As a result, when you say that Americans spend "next to nil for stem cell research, because of US policies" and then ask the U.S. government to put "a few tens of billions into stem cell therapy", it sounds like you don't know what you're talking about. There's more than the U.S. government interested in this type of research: there's private interests and other governments. Even at our supposedly diminished funding, we still outpace that of the entire EU. Also, we don't devote more than a couple tens of billions to all medical research in the first place. I can't tell if you're asking to triple the current funding levels (and we could expect that this would attract a lot more cranks and waste, too) or to ignore all other medical research. Neither approach is very realistic.

The U.S. is not "doing nothing" about it. We're just not willing to make certain compromises. U.S policy avoids the wastefulness of either extremes while remaining mindful of the interests of both sides of the issue.

I drank what?

[ Parent ]
What defines and constitutes a person? (2.33 / 3) (#5)
by Kasreyn on Sat Jul 30, 2005 at 02:56:51 PM EST

If it's a set of organs, then clearly there is only one person involved and the excess stuff can ethically be removed. If it's a set of DNA, then once again only one person is involved. If it's higher brain functions - which, being the main thing that seperates humans from "lesser animals" to whom we grant no protections - then again there is only one person involved, as Mary's brain was "primitive".

Are there any other definitions of personhood that would have counted Mary as a person distinct from Jodie? In any case, I feel the only possible correct decision was made.

"Extenuating circumstance to be mentioned on Judgement Day:
We never asked to be born in the first place."

R.I.P. Kurt. You will be missed.
Souls. (2.66 / 3) (#14)
by ubernostrum on Sun Jul 31, 2005 at 02:08:14 AM EST

For various reasons, different religious groups believe that, despite the autonomy or sentience of the actual bits of flesh in question, each conjoined twin is a separate soul, and thus each has its own right to life.

You cooin' with my bird?
[ Parent ]
working minds (none / 1) (#35)
by Roman on Tue Aug 02, 2005 at 01:27:55 AM EST

As I understand it Mary does not have a developed mind. As an atheist I don't believe in souls. So, a working mind that is self-aware can be from my point of view considered a seperate person. If there is no mind, then the body is not really a fully functionning person (remember Terry Shiavo.) Since a fully functionning person may die because a mindless person without some organs is attached to the fully functionning person, I say detach them and let the body of Mary take its course (a natural course that a body without a working heart will take.)

[ Parent ]
Good for you. (none / 0) (#44)
by ubernostrum on Wed Aug 03, 2005 at 03:15:36 AM EST

Now go find a more relevant place to post that thought.

You cooin' with my bird?
[ Parent ]
He should post it on Kuro5hin... [nt] (none / 0) (#52)
by artis on Wed Aug 03, 2005 at 03:13:58 PM EST

Can you know that you are omniscient?
[ Parent ]
Physical bodies (none / 0) (#48)
by paranoid on Wed Aug 03, 2005 at 05:46:00 AM EST

It looks like the child(ren) had about 1.8 bodies. Rounded to the nearest integer it's 2.

This makes possible a nice thought experiment. Imagine that the second "child", Mary, was born with less of a body. She doesn't have functioning lungs now, imagine she didn't have ANY lungs. Then remove all the rest of her body parts one by one (in imagination, not by cutting them off) - at which points does she stop being a person (according to the definition of some people)? What if she only had a brain and almost no face? What if the brain was connected to the brain of Jodie? What if they had 1.9 of a brain? 1.7? 1.5? 1.3? 1.1?

Obviously, at one end of this sequence you have one and exactly one person. At the other you have 2 persons (two easily separated conjoined twins). Somewhere in the middle you have Mary and Jodie. But it's clear to me that any line you can draw between 1 and 2 persons is largely arbitrary. The conclusion is that in some cases there is no obvious way to answer the question "Is this a person?". The corollary is that we should not strive to answer this unanswerable question - is Mary a person, but instead think about the situation in objective terms.

Not "here are two girls and we need to kill one to let the other live", but "here is the result of a abnormal pregnancy, can we salvage some human babies from that mess?".

The sooner we realise that there is no such thing as "human", the better for us, because we are bound to deal with even more complex issues (cyborgs, AI, uploaded humans, cryopreserved humans, collective minds, enhanced humans, etc.).

[ Parent ]

I wonder what Gracie/Jodie will think (2.33 / 6) (#13)
by Tragedy of the Kurons on Sat Jul 30, 2005 at 11:31:49 PM EST

when she grows up and finds out her parents wanted to let her die for their religious convictions? Culture of life indeed.

"That is a mean website. Some people are just mean and rude."

What I think is very likely to happen. (2.80 / 5) (#19)
by topynate on Sun Jul 31, 2005 at 03:27:29 PM EST

Gracie will adopt her parent's religious beliefs, despite her being alive to hold them as a result of their negation. This will enable her to both love her parents and believe herself worthy of life. Any theological disagreement she may have as she grows up, no matter how small, will be felt by her parents to be an accusation of their trying to murder her. They will do anything to prevent her from forming this opinion of them. 'Anything' will be very heavy religious indoctrination. The young woman will stay in Malta, a deeply religious country.

She's in a very tight spot. She has only two alternatives, complete acceptance of her parent's moral authority over her own, or ostracism. She may be able to understand her parents even as she disagrees with their choice, but they won't see it that way.

This line of thought depresses me.

"...identifying authors with their works is a feckless game. Simply to go by their books, Agatha Christie is a mass murderess, while William Buckley is a practicing Christian." --Gore Vidal
[ Parent ]

Me too... (none / 0) (#32)
by eightyford on Mon Aug 01, 2005 at 08:41:15 PM EST

Thank you very much for your opinion, but now I'm depressed too! You're insight is pretty amazing though, in a pessimistic/jaded sort of way.

New Religion Message Board
[ Parent ]
spelling (none / 0) (#33)
by eightyford on Mon Aug 01, 2005 at 08:43:27 PM EST

I really have to start spellchecking... your, not you're. And pessimistic can't be right... right? ugh!

New Religion Message Board
[ Parent ]
the choice is clear (1.50 / 14) (#15)
by circletimessquare on Sun Jul 31, 2005 at 02:11:46 AM EST

let them both die so that we shall feast on their immortal souls and live forever

The tigers of wrath are wiser than the horses of instruction.

Don't you know? (2.00 / 3) (#18)
by topynate on Sun Jul 31, 2005 at 03:18:06 PM EST

It takes thousands of deaths to supply enough energy for eternal life even for one person!

"...identifying authors with their works is a feckless game. Simply to go by their books, Agatha Christie is a mass murderess, while William Buckley is a practicing Christian." --Gore Vidal
[ Parent ]
Thousands isn't enough. (1.50 / 2) (#24)
by your_desired_username on Sun Jul 31, 2005 at 09:55:05 PM EST

Chairman Mao killed between fifty and seventy million. He didn't achieve eternal life. You'll need more - much, much more.

[ Parent ]
It seems a lot of infamous killers have done it (none / 0) (#38)
by nollidj on Tue Aug 02, 2005 at 09:21:52 AM EST

Hell, Jack the Ripper was skilled enough to kill far fewer than Stalin or Mao and still get movies and cult followings. It was the way that he did it that got him his snatch of immortality. Hitler, Stalin, Mao ... through the deaths they wrought, they have all transcended the little death that befell so many who were prey to their political machines. It really is a kind of perverse necromancy, isn't it?

[ Parent ]

Jack the Ripper (none / 0) (#41)
by skavookie on Tue Aug 02, 2005 at 05:06:56 PM EST

Yes, but Jack the Ripper had help from the Vorlons.

[ Parent ]
who cares? (1.33 / 3) (#26)
by dimaq on Sun Jul 31, 2005 at 11:45:13 PM EST

I mean seriousely, who cares? your chances of conceiving a conjoined twin and then be stuck in a legal wrangling between catholic fanatics and church of england (owned by the king) are really rather slim! so the court gets to decid what the society norm is. so $%^$ what?

King? (none / 0) (#31)
by eightyford on Mon Aug 01, 2005 at 08:21:21 PM EST

I didn't know Elizabeth had died. But anyways, obviously the submitter cares about the subject. Many other people care about ethics too, even the non-religious like myself.

New Religion Message Board
[ Parent ]
Let both (1.25 / 8) (#34)
by uptownpimp on Tue Aug 02, 2005 at 12:31:36 AM EST

die and have more sex... catholics are good at having kids.

My name is actmodern and I approve of this message.
Religious people are very evil. (1.20 / 5) (#36)
by dostick on Tue Aug 02, 2005 at 06:38:41 AM EST

This example is same as religious people bring their children to church therefore brainwashing young minds before children can think on their own.

My site: http://blog.enargi.com
Edit queue? (2.60 / 5) (#37)
by bakuretsu on Tue Aug 02, 2005 at 06:57:37 AM EST

Apostrophes are never, ever used in plurals. How did this make it to the front page in this sorry state? "Descision's"? How about "decisions."

respect the descision's they make for themselves. Autonomy has to do with people deciding what they wish to do on the basis of their own views and feeling's. Obviously these children were too young to be given autonomy in their own right and do not fall into the framework that constitute  Gillick Competency. Their parent's were to act

The edit queue exists so that a piece can be vetted by members of the community to catch these little snags.

-- Airborne
    aka Bakuretsu
    The Bailiwick -- DESIGNHUB 2004

Agreed (none / 0) (#39)
by MoebiusStreet on Tue Aug 02, 2005 at 10:52:38 AM EST

I don't normally post just to nit, but the quantity of times this error occurred led to distraction, making the whole thing difficult to read.

[ Parent ]
A note. (none / 1) (#42)
by bakuretsu on Tue Aug 02, 2005 at 05:31:25 PM EST

I should have said that apostrophes are never, ever, ever used in plurals when the plurals are not possessive. Of course you can say "the teachers' rooms were very clean" when what you mean is that the rooms owned by the teachers (note that there are many teachers) were very clean.

None of the examples I bolded in the above paragraph were possessive plurals, however. It really curdles my milk to see signs that say things like "ALL DVD'S ON SALE." It is okay for an S at the end of a word to touch other letters. They won't turn them gay or anything.


-- Airborne
    aka Bakuretsu
    The Bailiwick -- DESIGNHUB 2004
[ Parent ]

Reply (none / 0) (#45)
by rabbitfoot on Wed Aug 03, 2005 at 04:48:52 AM EST

I am all in favour of constructive critism, it's fundamental to learning, however, your comments would have been far more useful at the editing stage, when something could actually have been done about it. As you say, thats exactly what the edit queue is for, "to catch these little snags".

[ Parent ]
Ah. (none / 0) (#49)
by bakuretsu on Wed Aug 03, 2005 at 07:08:47 AM EST

I came along too late, I guess. I used to check K5 every day but now it doesn't seem worth it to me. It's an even more depressing reflection on the K5 community that those snags were not caught at the editing stage.

-- Airborne
    aka Bakuretsu
    The Bailiwick -- DESIGNHUB 2004
[ Parent ]
Abortion, anyone? (3.00 / 3) (#43)
by black orchidness on Tue Aug 02, 2005 at 09:16:32 PM EST

"She is alive because, and only because, she sucks the lifeblood of Jodie and her parasitic living will soon be the cause of Jodie ceasing to live."

Does any one recall the Judith Jarvis Thompson argument about the dying violinist? The judge's language about parasites just reminded me of that. True, getting pregnant will most often not kill the mother, but the fetus is a parasite depending wholly upon her for its existence. One of the other definitions for personhood is viability, something Mary did not posses after her heart and lungs failed. Perhaps this decision could be used by pro-choicers. You have to admit it's a pretty big conundrum to call a baby both a parasite and a human being in the same oh-so-empathetic paragraph.

Not as though it matters anyway. Premature babies (that are otherwise healthy) don't have viability either. Without their little warming incubator thing and special care, they would die. I think the viability argument has been erased by science, but that the parasitic one still has merit.

Speaking of the violinist (none / 1) (#53)
by DEBEDb on Wed Aug 03, 2005 at 07:24:41 PM EST

Funny you should say that. Thompson was my prof
for the Introduction to Philosophy class, so
that's why I remember the violinist essay. I
found it lacking (and I usually enjoy the
hypotheticals philosophers think up for their
narration as much as for analytical exercise).
While I am strongly in favor of a woman's choice, a simple counterargument to Thompson would be
that nowhere does her hypothetical state that
the woman was engaging in something that she knew
would result in the outcome. That right there,
I think, negates the argument. Too bad.

[ Parent ]
Best way to deal with complex situations (none / 1) (#46)
by paranoid on Wed Aug 03, 2005 at 05:22:27 AM EST

The main reason for controversies is that people are idealists. Not idealists in the common meaning, those who believe in ideas, such as the ideals of humanism, but in the philosophical sense, those who beleive that ideas existed before real world or that only they exist.

People assume that the idea of "human" exists in an abstract form outside of this world. They forget that it's just a label and in some cases it is questionable to apply it.

Jodie and Mary should not have standard human rights, because they are not standard humans. The simplistic reasoning "has many human characteristics => is human => should have all human rights" is invalid.

Of course, people who are most often guilty of these faults in logical reasoning are the ones that is most difficult to explain this to. They'd rather listen to what their Catholic shepherds tell them...

Show me a "standard human"... (none / 1) (#50)
by CptPicard on Wed Aug 03, 2005 at 12:04:33 PM EST

The very point of the universality of human rights and the preference for their broad applicability is that someone can't just randomly come about and say "oh but YOU don't qualify, so you can be snuffed out". Who says who is human enough? You?

The last time someone started rigorously defining who exactly qualifies as members of the healthy standard-Volk, we got the T4 euthanasia program...

Yes, there are borderline cases where the label of "human" doesn't quite stick anymore and we get issues like this, but I'd always prefer being safe than sorry... even if it made me a bleeding-heart softy or something.

On another note, I find it ominous that even the court saw it neccessary to give its grounds using such poisonous rhetoric... this was a tragedy where, unfortunately, the only reasonable solution was to separate, but yet they chose to base their argument on an outright demonization of Mary as a kind of "lifeblood-sucking parasite".

Come on. It's hardly her fault to be born in such a condition. If the only way to save at least one of the babies is what was done, that's it... no need for all the invective. Mary's memory deserves better.

The attitude seems to be a sign of the times. Once again, like in the 20s and 30s, the only right there is is the right to struggle for survival...

[ Parent ]

You don't get it (none / 0) (#54)
by paranoid on Wed Aug 03, 2005 at 08:41:05 PM EST

The very point of the universality of human rights is that this universality is impossible in the general case.

You can say "negros should have the same rights as whiteys", because the differences between races are so small. But, last time I checked children still were discriminated in 100% of the societies on Earth. Children are apparently considered "less human" (though few are willing to put it that way) and they do not enjoy full human rights.

The whole point is that we do not accept the idea of universal human rights, because there are no standard humans! There are no universal rights! This is fiction, a myth, a fantasy, an illusion. But rather than accept this simple fact and develop a rational attitude based on reality you instead choose to believe in this fiction, pretending that all humans somehow have equal rights and that every object that can be even remotedly considered human for a second is 100% real actual fully valid human.

No. And don't give me that shit about euthanasia. If you want to compare my position with that of Nazis, please specifically say, what exactly aspect of Nazi policies do you have in mind and how is that similar to something that I propose. But no insinuations, ok?

[ Parent ]

Idealists (none / 1) (#55)
by gdanjo on Wed Aug 03, 2005 at 10:53:13 PM EST

But rather than accept this simple fact and develop a rational attitude based on reality you instead choose to believe in this fiction, pretending that all humans somehow have equal rights and that every object that can be even remotedly considered human for a second is 100% real actual fully valid human.
The reality is that some people are considered less human than others - this is a FACT. The ideal is that all humans should be treated equal - this is an AIM. Your argument that we should base our definitions on fact rather than an ideal aim is severely flawed: it ends in infinite perpetuation of the status quo.

In your original post you say:

Of course, people who are most often guilty of these faults in logical reasoning are the ones that is most difficult to explain this to.
Logical reasoning depends on binary axioms - either the axiom applies, or it does not. This is the case for mathematics, and it is also the case for reasoning about human beings. Having axioms that don't match your own world-view (in this case, universal human-ness) does not imply illogical reasoning.

Which brings me to:

They'd rather listen to what their Catholic shepherds tell them...
You may as well have said "they're religious, therefore illogical, therefore their opinion doesn't matter" and saved a few hundred words or so.

Dan ...
"Death - oh! fair and `guiling copesmate Death!
Be not a malais'd beggar; claim this bloody jester!"
[ Parent ]

Binary? (none / 1) (#59)
by paranoid on Thu Aug 04, 2005 at 06:37:55 PM EST

You assert that reasoning about human beings should be based on binary axioms. There is no proof and this simply doesn't make sense. There is no way to safely determine the humanness of each and every object in a binary "black or white" way.

There is no such quality as humanness that is either present in something or not. There are degrees of humanness, unless you are willing to take it upon yourself to define completely arbitrary limits for everyone else to follow.

Do you think that a rotting corpse is a human? A brain dead person? A person in a state of clinical death? A person with a heart attack going on? A healthy person? I don't doubt for a moment that you are completely willing to draw a line somewhere, insist that it's placed there by god or something and everyone who doesn't agree is a Nazi. But this is illogical and wrong. The ideal that all humans be treated equal, but only those, whom your morality and set of beliefs consider humans, is a horrible nightmare, not an ideal. The ideal is a world where we respect reality and act in accordance with it.

[ Parent ]

nope (1.50 / 2) (#61)
by gdanjo on Thu Aug 04, 2005 at 10:44:11 PM EST

You assert that reasoning about human beings should be based on binary axioms.
No, I assert that reasoning about anything is based on binary axioms. If you simply disagree with the axioms, it does not follow that the reasoning itself is necessarily illogical.

I'm specifically referring to this statement of yours:

Of course, people who are most often guilty of these faults in logical reasoning are the ones that is most difficult to explain this to.
Reasoning based on the axiom "all humans are equal" is NOT illogical simply because you disagree with the axiom.

There is no such quality as humanness that is either present in something or not. There are degrees of humanness, unless you are willing to take it upon yourself to define completely arbitrary limits for everyone else to follow.
Certainly, there are degrees of "humanness" that must be considered when deciding whether an entity is human or not. BUT - and this is a BIG but - the end result should be binary: entity X is either human, or it is not; reasoning above this must then take into account this binary fact, and MUST NOT discriminate between entities of differing levels of humanity - this is the ideal I'm talking about.

The alternative is to allow varying degrees of "humanness" to contaminate our reasoning about our actions towards other human beings, which is precisely the foot-in-the-door needed for all forms of racism to exist - after all, at the height of the slave trade black people were considered humans: "more human" than dogs but "less human" than white people.

The ideal that all humans be treated equal, but only those, whom your morality and set of beliefs consider humans, is a horrible nightmare, not an ideal.
(emphasis mine) Why is it my morality that sets the line between human and non-human? I never said anything about the lines of reasoning taken to determine whether an entitiy is human or not, I only talked about the consequences after this decision is made.

Methinks you're letting your hatred for religion cloud your reasoning about this subject.

The ideal is a world where we respect reality and act in accordance with it.
Crime has, and will always, exist; should I respect this reality and forget about "idealist" laws against crime? Or should I just accept that you're full of shit?

Dan ...
"Death - oh! fair and `guiling copesmate Death!
Be not a malais'd beggar; claim this bloody jester!"
[ Parent ]

Axioms vs. axioms... (none / 0) (#56)
by CptPicard on Thu Aug 04, 2005 at 10:50:15 AM EST

Gdanjo's response was concise and good, but here I go as well...

Your own response shows that you DO consider there to be differences that are small enough to be ignored. This is a value judgement. Where one draws the line tends to be subjective, and therefore erring on the side of caution when in doubt is preferable.

Now, what kind of rights do we give to those who do pass the humanness litmus test... this is a different matter. Actually as a secular humanist I do not really believe in any sort of Platonic separate existence of universal rights either. Rights are what we choose to grant. In this view, all rights are equally much "fiction".. they are axiomatic. As an extreme example, even if I killed someone on the spot, there is no immediate lighting bolt coming out of the sky to kill me in revenge. I grant you this much.

However, it is a reasonable assumption to make that the people who seem human around me are experiencing a similar situation to what I have in my own consciousness. Therefore, for the person I snuffed out, it would suck to get killed by me. This means I choose to grant them the right that I don't go on shooting sprees.

The problem in your logic is that as gdanjo pointed out, you aggressively exclude the middle. Such trivializations tend to result in systems that are incomplete and often result in outright contradictions. Therefore either the logic or the axioms are wrong.

Yes, some people are more useful than other people for particular tasks. Some people are too young or too dumb for their own good and need guidance and protection. This, however, does not make them "less human" or serve as proof that there shouldn't be human rights whatsoever because we can't neatly classify human beings into a nice box where once size fits all. They are obviously human beings, and this shows that humanity is a broad concept! It would seem to me that to argue that the variation in humans causes the whole concept of humanity to be invalid is absurd.

Also, it does not follow that just because there is no "natural law" that would have universal human rights as a consequence (just as much as there is no natural law that has, say, the libertarian dogma as consequence), we <i>couldn't</i> do anything as to their effect. To argue that would amount to an outright refusal of free will.

As regards Nazis... I call things as I see them, and I am not ashamed of it. You may not be waving a swastika flag, but the whole point was that there exists a similar callousness towards human life in a couple of modern ideologies and what those guys had back then. It is all a matter of rationalizing away the other person's right to exist on the basis of "non-viability" which exists somewhere between subjective (a black person being beaten up by a skinhead is not viable for long) and objective (conjoined twin without heart and lungs is not alive for long)...

Just because your value system eventually results in nasty conclusions, is of course no reason to change a perfectly logical and beautiful construct, eh?

[ Parent ]

Slight addendum regarding Nazism... (none / 0) (#57)
by CptPicard on Thu Aug 04, 2005 at 11:01:28 AM EST

I do need to point out that my reference to euthanasia etc. was particularly directed towards the wording of the court opinion and the attitude taken towards Mary. It was not specifically directed against your person or own views. It is merely an example of a historical consequence I see as naturally following from the POV where a broad conception of human rights is subverted to a survivalist logic...

A sign of the times, as I said.

[ Parent ]

You got it all wrong (none / 0) (#60)
by paranoid on Thu Aug 04, 2005 at 06:55:24 PM EST

I am not excluding the middle, on the contrary, I am the one who asserts its existence. The middle is something in between, a state between being human and not being one. The middle is where you are a human to some degree.

It is important to recognize it precisely for what it really is. In every human culture the idea of "not fully human" is present. It's normal, decent, respectful, the only problem that we constantly try to gloss over it. Even our modern culture realises that 1-year old babies are not fully human. Meaning, of course, that they are not "fully developed human beings", even though no one doubts that they belong to our species homo sapiens sapiens.

And since these creatures are only partially human, we do not give them full human rights. This is only natural and this is the reality. This is how it is and the only way it can be. Becoming a human is a gradual process. You start with essentially nothing and end up with a human. Drawing a line somewhere in the middle is horribly mistaken, even if you try to justify it with the fact that "humanity is a broad concept".

Yes, it is, but everyone is human to a different degree. Yes, for most practical purposes it makes sense to lump the top end together and pretend that those who are "95% human", "98% human" and "99% human" are all "fully human". But because we have certainty at the top should not lead you to believe that this certainty exist in the darn middle.

It's not nazism to say that this middle is a grey area, it's common sense. In fact, this is the opposite of nazism, because I explicitly refuse to draw the line. I may accept that schizophrenics, disabled people, homosexuals, even (for the sake of argument) Jews, Gipsies and my own race are slightly less human than Aryan blue-eyed blond beasts, but I won't deny the "lesser humans" all their rights. Jews may be inferior to Germans, but that doesn't make them equal to rats.

Nazis, on the other hand, drew a line and sent you to the gas chamber if you were on the weong side of it.

So you are completely wrong. If you assert that humans are either 100% or 0% human, then it's you and not me who is thinking like a Nazi. The only way to avoid it is inclusionism - everyone and everything, which is even remotedly human or human-like is 100% human. But this is the road which would lead you away from secular humanism and into the camp of religious right, arguing relentlessly that stem cells should have human rights.

See? On the one end of the spectrum you have Nazi butchers. On the other hand Christian fundamentalists. And the right place for all secular humanists is right next to me - in the middle, where we accept that the line between human and non-human is blurred and human rights should be measured to each (meaning primarily those stuck in the middle) according to his degree of humanness.

[ Parent ]

Solomon's decision (none / 0) (#47)
by paranoid on Wed Aug 03, 2005 at 05:37:51 AM EST

This looks even more complicated than the famous King Solomon's decision. :) On the one hand, those who agree to cut the child(ren) are wrong. On the other, the mother who agrees to have both her kids die is not the real mother. What would King Solomon do?

Who fucking cares? (none / 0) (#51)
by Fen on Wed Aug 03, 2005 at 12:12:26 PM EST

Why are people worrying about this shit? Is one of these kids gonna grow up and suddenly bring everyone together in world peace?

Euthanize them both...there's better things to do for everyone else.

"Equal rights to live" (none / 1) (#58)
by orestes on Thu Aug 04, 2005 at 04:37:01 PM EST

Is it really the standpoint of the Catholic church that an embryo or fetus has a greater right to live than an infant?

[ You Sad Bastard ]
The question really... (none / 0) (#62)
by Mysidia on Mon Aug 08, 2005 at 12:54:12 AM EST

Should one child have an obligation to sacrifice its very life just to prolongue the life of another by at most a few weeks or so, when it is certain that the other will die no matter what, but that the one supporting them both could survive on its own?

Obviously, not. The right thing to do is to give the one who will be able to live on its own a chance.

Religious ideals are one thing, but they must be set aside when the rights of another individual are in question, so that the proper course of action can be judged reasonably.

An infant has had no time to develop its own religious beliefs, a parent or doctor has no right to impose their ideas on it, their obligation is to respect its best interests, with the strongest weight given to the one who has a reasonable chance of survival. Placing religious ideals above the preservation of human life would be a terrible abuse...

-Mysidia the insane @k5
Separating conjoined twins. | 62 comments (44 topical, 18 editorial, 0 hidden)
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