Surgeons Complete Operation on Conjoined Twins

L O N D O N, Nov. 8, 2000 -- Surgeons have completed a lengthy operation to separate conjoined twin girls, a complex procedure that involved allowing one of the girls to die soher stronger sister would have a chance at a normal life.

St. Mary’s Hospital in Manchester said the stronger twin, known only as “Jodie,” survived the surgery and was in “critical but stable” condition. “Unfortunately despite all of the efforts of the medical team, Mary sadly died,” the hospital said in a statement.

The complicated procedure that ended at 5 a.m. local time on Tuesday followed months of legal dispute over whether the parents could refuse surgery and let nature take its course.

Jodie and Mary were born at St. Mary’s Hospital on Aug. 8,joined at the lower abdomen, and doctors said if they were not separated, both would die within months. Doctors said surgery could allow Jodie to have a normal life, but Mary’s heart and lungs were non-functional and she would not survive once she was separated from Jodie’s aorta.

The twins’ parents — identified only as Roman Catholics from the Maltese island of Gozo in the Mediterranean — opposed the operation for religious reasons but decided not to contest a Sept. 22 decision by the Court of Appeal that the girls can be separated.

Living on Borrowed Time

The court had struggled with the issue of whether the surgery would amount to intentionally killing Mary. Two medical specialists appointed by the court endorsed surgery.

“The sad fact is that Mary lives on borrowed time, all of it borrowed from her sister,” Lord Justice Alan Ward said in the Court of Appeal ruling. “She is incapable of independent existence. She is designated for death.”

The official solicitor’s office, which represents children’s interests in court, had provided legal representation for both children.

Last Friday, judges rejected a last-minute appeal by the Pro-Life Alliance, an anti-abortion group that wanted the case to be decided in the House of Lords.

According to testimony at the Court of Appeal, surgeons expected to begin the operation by exploring the twins’ anatomy. The separation process would start with the pelvic bones and then go to the spines, where the twins were joined.

“Finally and eventually we have a major blood vessel, which is the continuation of Jodie’s aorta, which is bringing blood across to Mary, and similarly the vena cava, which is returning blood from Mary to Jodie. Those would need separating, dividing. It is at that point that we would expect that Mary would then die,” the court’s judgment said, quoting a surgeon who was not identified.

Doctors say Jodie will probably need further surgery toreconstruct some organs damaged in the surgery, including her rectum, sexual organs and lower abdomen. She is also expected to need skin grafts.

The Associated Press and Reuters contributed to this report.