Separation of conjoined twins from the shari'ah and common law perspectives: the legal and ethical conundrum

• Main Authors: Jahn Kassim, Puteri Nemie, Alias, Fadhlina
• Format: Conference or Workshop Item
• Language: English; English
• Published: World Association for Medical Law (WAML) 2015
• Subjects: K Law (General)
• Online Access: http://irep.iium.edu.my/44437/2/Separation_Conjoined_Twins.pdf; http://irep.iium.edu.my/44437/6/44437.pdf; http://irep.iium.edu.my/44437/
• Institution: Universiti Islam Antarabangsa Malaysia

The birth of conjoined twins is a comparatively rare event, constituting 1 in 100,000 births. Being a product of a single fertilised egg, these twins are believed to be the result of an incomplete division of embryo, which inhibits complete development of various organ systems. As a result, they usually suffer from physical malformation manifested in for instance, conjoined hearts, lungs, livers, limbs or even genito-urinary tracts. As such, their chronic medical condition tend to require surgical intervention. However, separating them has triggered a plethora of legal and ethical issues as separation means the possibility of sacrificing one twin if they are sharing organs. This inevitably creates a range of ethical dilemmas, particularly, in choosing between sanctity of life and quality of life as the survival of one twin threatens the survival of the other. In certain circumstances, separation may not lead to the demise of the other but may cause severe harm to the other or a possible hazard to at least one twin’s cognitive outcome. Nevertheless, in spite of their physical attachment, the twins are legally and morally distinct and are different individuals with competing needs and interests. Legal issues arising from their separation such as informed consent, parental consent, the determination of the “best interests” criterion and murder has been much debated in the court of law. Thus, this research paper seeks to discuss the legal as well as ethical issues and dilemmas arising from the separation of conjoined twins from the common law and shari’ah perspectives.