LAST WEEK, the world was saddened to learn of the deaths of two conjoined Iranian twins connected at the head. The twins had been living with their heads connected for both of their full lifetimes of 29 years. The doctors operating on the twins had acknowledged that the operation would be highly risky and had only a 50 percent chance of success. Even with the less than ideal chance of success that the twins faced, and the unfortunate result of the surgery, the decision to separate the twins was still ethically correct.
Many people may question the decision of the twins and the doctors to proceed with such a risky medical procedure. After all, the twins were healthy and well educated. Clearly their innate physical connection had not adversely affected their health or intellects. They had lived together for over a quarter century, so it is easy to argue that they most likely could have lived out their lives connected at the head. The surgery was not a life-or-death issue, or even of a preventive or health-improving nature. There are, however, many other important issues at hand that are not physical or mental, but rather social and personal, which justify the decision to conduct the operation beyond any reasonable doubt or hesitation.
It is difficult, if not nearly impossible to imagine what it would be like to live with someone else, even someone as close as a sibling, attached at your head. It would be impossible to do anything by yourself: sleeping, eating, even going to the bathroom would inevitably require unwanted company. Your life would not be one's own, but would have to be shared always for better or worse with your sibling.
Although some of the activities mentioned above, such as eating and sleeping may be made uncomfortable or difficult by being connected at the head, there are other more important life events, namely marriage and procreation that would probably become impossible in the conjoined twins' case. It is unlikely that a man would want to marry both twins, or that if both twins were to be married to different men, that their respective husbands would want to be forced as the twins were to live almost every instant of life together. Such an instance would not be fair to the husbands, as it was not for the twins, and there is probably no man that would take one of the twins' hands in marriage for that reason.
Copulation would be possible although difficult and awkward for the twins not only because of the necessary proximity of one to the other, but also because, with the probable lack of a partner, it could not occur. Similarly, childbirth and child rearing would be difficult but probably not an issue for either twin to worry about while they were connected. Among the other myriad problems the twins faced through their situation, because it is all but essential for humans to have children and continue their family line, and unfair for the twins to most probably be deprived of this natural right, there was no other alternative than to operate.
The twins were living in a virtual prison, incarcerated by each other's inseparable presence, placed into that situation by nature. The doctors attempting to separate the twins were acting as liberators. They represented the only opportunity for the twins to lead a normal individual life, free from one another. Such circumstances raise critical questions on whether it would be better to die, or to continue living in the prison cruelly designed by nature, devoid of certain aforementioned freedoms which are available to nearly everyone else on the planet.
The conjoined Iranian twins accepted the risk of death in hopes that they would be freed from their bondage in order to be able to lead more normal lives. For them, the possibility of death, no matter how great, was preferable to living as they had for their entire lives. The doctors who operated on them and witnessed the tragic conclusion of the surgery should not question their intents, for they were correct. Perhaps the surgery may have been conducted differently in technical detail and yielded more successful results. But the answers to such questions will never be known and the doctors should rest assured with the knowledge that they represented the twin's best and only hope for a normal, happy and individual life.
(Alex Rosemblat is a Cavalier Daily columnist. He can be reached at arosemblat@cavalierdaily.com.)
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