The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index; none of the 29 sources its claims cite is checked for support yet.
One into two will not go: conceptualising conjoined twins
Open accessAbstract
This paper is written in response to controversial judicial decisions following separation surgery on conjoined twins "Jodie" and "Mary". The courts, it is argued, seem to have conceptualised the twins as "entangled singletons" requiring medical intervention to render them physically separate and thus "as they were meant to be", notwithstanding the death of the weaker twin, "Mary". In contrast, we argue that certain notions, philosophical and biological, of what human beings are intended to be, are problematic. We consider three compelling conceptualisations of conjoined twins and advocate a model that conceives them as two psychologically separate individuals who happen to share a body, the sharing of a body being integral to the individuality of each twin. While we reject an "essentialist" view of the conjoined state, a view which might render separation surgery unthinkable in all cases, we nevertheless argue against an "adversarial" interpretation of conjoined twins' respective best interests. We maintain that the physical entanglement should be regarded as a shared problem rather than one posed by one twin to the other. And if, after deliberation, separation surgery is deemed the "least detrimental alternative" or the "lesser of two evils", then there should be recognition of what conjoined twins will lose, as well as gain, through separation. The current drive to separate twins at all costs may evince a deeper unease with bodily configurations that appear to threaten the premium that the Western ethical and legal tradition places on personal sovereignty, and the physical circumscription that such sovereignty assumes.
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“While we reject an ''essentialist'' view of the conjoined state, a view which might render separation surgery unthinkable in all cases, we nevertheless argue against an ''adversarial'' interpretation of conjoined twins' respective best interests.”
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“We argue that this is difficult to maintain.”
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“Brooke LJ appears to have derived his notion of bodily integrity (and inviolability?) directly from the sanctity of life doctrine: ''the doctrine of the sanctity of life respects the integrity of the human body'' (Re A, 1 1051).”
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- Not matchedcites Re A
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In the paper
“As a result, they were led quite easily into using language that suggested that Jodie and Mary (or at least one of them) were in wrongful and harmful contact with each other.”
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“In English law, the fetus only acquires full legal protection when it is born and has a separate existence from its mother.2 This is the so called ''liveborn'' principle.”
What the sources say
- Not matchedcites [2] Paton v Trustees of BPAS [1979] QB 276, [1978] 2 All ER 987 (QBD) .
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§ CONCLUSION
“The court's reasoning is a good illustration of Canguilhem's observation that ''the abnormal, while logically second, is existentially first''.21”
§ References
“20. Canguilhem G. The normal and the pathological [trans Fawcett C R]. New York: Zone Books, 1991:243.”
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In the paper
§ **
“In a commentary on this argument Davis claims that what is important is not just an unbroken history of being joined, but the sharing of a body.20”
§ References
“19. Davis JK. Commentary on Thomson's violinist and conjoined twins. Camb Q Healthc Ethics 1999;8:435-9. 20. Canguilhem G. The normal and the pathological [trans Fawcett C R]. New York: Zone Books, 1991:243.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ THE WAY FORWARD
“Kenneth Himma explores this relationship in the case of hypothetical conjoined twins, known as Tom and Joe.19”
§ References
“18. Himma KE. Thomson's violinist and conjoined twins. Camb Q Healthc Ethics 1999;8:428-35. 19. Davis JK. Commentary on Thomson's violinist and conjoined twins. Camb Q Healthc Ethics 1999;8:435-9.”
Citations
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Kaveny, M. C. (2001) · Theological Studies · doi:10.1177/004056390106200404 · Cited by 10
Thomson's Violinist and Conjoined Twins
Himma, K. E. (1999) · Cambridge Quarterly of Healthcare Ethics · doi:10.1017/s0963180199004041 · Cited by 7
Davis, J. K. (1999) · Cambridge Quarterly of Healthcare Ethics · doi:10.1017/s0963180199214041 · Cited by 3
Stein, R. C. (2000) · Journal of Pastoral Care · doi:10.1177/002234090005400411 · Cited by 2
Commentary on Thomson's violinist and conjoined twins.
Davis, J. K. (1999) · PubMed · Cited by 1
Research works printed but not linked: 3
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- 1982, Nat Hist, 91, 18
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Cited by
Conjoined twins—past, present, and future
Rabeeah, A. A. A. (2006) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2005.12.045 · Cited by 70
Vaginal Delivery of Dicephalic Parapagus Conjoined Twins: Case Report and Literature Review
Harma, M. I., Harma, M., Mil, Z., et al. (2005) · The Tohoku Journal of Experimental Medicine · doi:10.1620/tjem.205.179 · Cited by 42
“Sacrifice of one individual to save another is supported by most religions and by courts, although some ethicists disagree with assumptions made in legal analyses (Atkinson 2004; Bratton and Chetwynd 2004 ).”
BackgroundInfluentialAnaesthesia for conjoined twins
Thomas, J. (2004) · Child s Nervous System · doi:10.1007/s00381-004-0980-9 · Cited by 27
Three-dimensional ultrasound for prenatal assessment of conjoined twins: additional advantages?
Wataganara, T., Ruangvutilert, P., Sunsaneevithayakul, P., et al. (2017) · Journal of Perinatal Medicine · doi:10.1515/jpm-2016-0381 · Cited by 15
“Significant ethical and legal arguments have consistently been raised when it comes to prenatal management and postnatal surgical separation [4].”
BackgroundGêmeos unidos e autorização judicial para o aborto
Nomura, R. M. Y., Brizot, M. D. L., Liao, A. W., et al. (2011) · Revista da Associação Médica Brasileira · doi:10.1590/s0104-42302011000200020 · Cited by 11
“IG no diagnóstico, semanas, mediana (mín-máx) 20 (14-32) 24 (22-26) 0,050”
Influential
Metadata
- Authors
- Bratton, M. Q., & Chetwynd, S. B.
- Affiliations
- University of Warwick (GB)
- Corresponding author
- Bratton, M Q
- Venue
- Journal of Medical Ethics
- Publisher
- BMJ
- Published
- 2004-06
- Volume
- 30
- Issue
- 3
- Pages
- 279-285
- ISSN
- 0306-6800 (ISSN-L)
- 1473-4257
- PMC
- PMC1733862
- OpenAlex
- W2096742274
- Semantic Scholar
- 55215a25a3aaaefa092aa4aa01c17de28725bddb
- Cited by
- 27
- References
- 16
- Citations by year
- 2025: 1 · 2024: 2 · 2022: 2 · 2020: 1 · 2017: 3 · 2016: 2 · 2012: 3
- FWCI
- 1.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Medical Ethics (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- Goddard Space Flight Center
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Social Sciences › Law › Medical and Health Sciences Research
- Keywords
- conjoined twins, separation surgery, individuality, essentialism, best interests, individual sovereignty, bodily integrity, twin identity, legal personality
- MeSH terms
- Child, Child Advocacy, Child, Preschool, Ethics, Medical, Female, United Kingdom, Homicide, Humans, Legislation, Medical, Surgical Procedures, Operative, Twins, Conjoined, Bioethical Issues, Ethical Analysis, Personhood
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