8 replies to this topic

[myworldline]

You happen to be one of two conjoined twins and other twin has terminally cancerous tumor that has not spread to you. As a consequence of that diagnosis you are given the choice of either going ahead the operation to separate when there is only a 1% chance of survival, or 0% if you don't. After much consideration you are given another choice of either going ahead with the operation or put in cryogenic suspension at Alcor.

Your other twin is fully reconciled to the fact the he/she is going to die because he/she is a born again Christian who believes in a Heaven. But you're not, you want to live

Edited by myworldline, 09 July 2003 - 01:12 PM.

[Bruce Klein]

Cryonics of course.... to easy.

[myworldline]

Cryonics of course.... to easy.

Operation of course, because my faith in cryonics is the same as my faith in a Heaven .........Zero

Edited by myworldline, 09 July 2003 - 12:22 PM.

[Lazarus Long]

Please, this is a specious and intentionally confrontational poll. It does not possess the most obvious choice which also had a GROWING risk; continue to live in mounting pain, sufferring, and risk to which they had NEVER become accustomed.

And a fourth; decide to save one over the other.

Not pleasant choices?

I have little more than disdain for those that try to second guess the ones that must face choices like these and try to replay their agony and despair of decision with all the aplomb & involvement of Monday morning quarterbacks.

I don't know what I, (We) would have done in their shoes but I applaud their profound courage and they made the choice knowingly.

It was a dismal failure from what I read and for many of the reasons their adopted father, a physician, thought it might be. The science and techniques hadn't yet caught up with the promise and the real isssue is when are we exploratory scientists in the quest of knowledge and skill, and when are we practicing healers that "first do no harm".

I would also like to say there are good guys and bad guys here but guess what it won't be so easy. At least take a moment to give consideration for these two courageous young women that lost their lives in a bold attempt to achieve better ones and thank them for what little piece of the human equation they have added understanding to.

[Lazarus Long]

http://us.rd.yahoo.c...dc&e=2&ncid=585

Failed Separation Surgery Fuels Ethics Debate
Wed Jul 9, 2:55 AM ET Science - Reuters
By Richard Hubbard

SINGAPORE (Reuters) - Prayers were held on Wednesday for conjoined Iranian twins who died after a marathon separation operation as a debate erupted over whether the pioneering surgery should have even been attempted.

The 29-year-old sisters, Ladan and Laleh Bijani, had made it clear they were willing to risk death in high-risk surgery for a chance to pursue separate dreams and live out their lives in different cities.

"They gambled and have lost," was the verdict of Singapore's Straits Times newspaper, which nevertheless noted the unprecedented procedure was "history in the making."

Iranians in the city state were in a somber mood as they gathered to hold prayers for the two women at a private home.

"I think the doctors have an obligation to fulfill the wishes of their patients," said Ali Homayouni, 25, an Iranian law student who had visited the twins in the hospital.

"It was their duty to make sure they do the best job they could given the circumstances," he said.


MEDICAL EXPERTS CRITICAL

But medical experts were more critical, concerned about the haste and motives behind the surgery.

"There are troubling aspects about this case," Dr Ian Kerridge, Associate Professor in bioethics at Sydney University's Center for Values, Ethics and the Law in Medicine told Reuters.

"...and one of them was the statement by one of the surgeons that they found it was more difficult than they had expected. To me that sets off a little bit of an alarm bell."

Kerridge suggested doctors could have let the girls wait for a year, talk to people who have not had the surgery or to people who felt it was wrong.

The man who had adopted and brought up the sisters in Iran, Alireza Safaian, a doctor himself, wept as he spoke to Reuters at his home in southwestern Tehran of the decision by his daughters and the Singapore doctors to go ahead with an operation.

"When they took them to Singapore, I knew they would bring back their bodies. They took them there and killed them."

Twins joined at the head occur once in every two million live births. A separation operation had never been tried on adults.


DOCTORS DEBATE MOVE

Dr Keith Goh, who led the team of 28 specialists and 100 assistants in the 52-hour long operation, defended the decision.

"I think that for those of us who were here over these last three days, for those of us who flew in from all over the world...the time and commitment is a convincing indication of their belief that the decision is correct," Goh told a news conference.

Ben Carson, director of pediatric neurosurgery at Johns Hopkins University in Baltimore who flew in for the operation the operation was worth it "even recognizing that the odds were not good. I think it was a worthy humanitarian effort."

But a neurosurgeon in Germany who declined to separate the twins when they were 14 said on Tuesday he was stunned the operation had even been attempted.

Madjid Samii, president of the International Neuroscience Institute in Hanover, said he had reluctantly turned down the twins' request after a month of examinations in 1988 showed the shared vein, which drained blood from their brains to their hearts, meant chances of survival were almost nil.

Facing journalists from around the world last month, Ladan said she and her sister had no fear: "We know that every surgery has a high risk." Laleh, sharing a cream headscarf, added: "We would like to see the face of each other without the mirror."

Australian medical ethicist Nic Tonti-Filippini said consent of the patients was not enough reason to go ahead with surgery.

"The profession actually has to be satisfied that it's a safe enough procedure," he told Reuters.

But among ordinary people, the view was more sanguine.

"It is the destiny of the twins," said Javad Najafi, 39, an Iranian living in Singapore.

An Iranian diplomat said the twins' bodies were to be returned to Iran on a flight leaving Singapore on Thursday.

The Straits Times in its editorial saw a silver lining in the cloud of tragedy.

"It is not the done thing to talk about boosterism when patients have died. But wrung of its emotion in what was literally a clinical job, Singapore will gain in international renown for its medical advances when the verdicts of professional peers are in."

[myworldline]

One more example of how the religiously irrational fall for this psuedoscience
hook line and sinker

However there will be a niche market for it with wealthy Christians who strongly reject the idea of cremation for religious reasons that the body needs to be resurrected in tact. This has been the tradional view of the Christian religion, and through all their wealth they can well afford the luxury of preserving their bodies by freezing to optimize their chances of a physical resurrection to Heaven. They believe that the cremated of decayed remains of bodies in the ground have no possibility of ever being resurrected.

MWI

Edited by myworldline, 10 July 2003 - 04:47 AM.

[Discarnate]

MWI - thank you for that article. Gives me a shred of hope that SOME religious people might accept the technologies coming w/out damning them as 'Godless abominations' or whatever...

Of course, you and I put different emphasis on how we read the article...

-Discarnate

[Lazarus Long]

The article was interesting MWL but I prefer Safire's slant on this as relevant to the broader implied discussion you are really addressing not the simplistic possible cross over to common religious memes.

http://www.nytimes.c...ion/10SAFI.html
The Risk That Failed
By WILLIAM SAFIRE

We no longer call them "Siamese twins," after Chang and Eng, the congenitally united brothers exhibited by P. T. Barnum in the 19th century. The twins now called "conjoined" are treated not as circus freaks but as infants deserving an attempt at surgical separation or — far riskier — as adults with the right to risk their lives in a quest for physical individuality.

In the 19th century, Chang and Eng had no such choice, and lived out their lives as sideshow curiosities, often called monstrosities, though they managed to father 22 children. In our time, two famed Iranian sisters, Ladan and Laleh Bijani — 29-year-old law school graduates whose brains were linked in the womb — found a hospital in Singapore and a score of neurosurgeons willing to carry out the Bijanis' decision to risk their lives for physical independence.

The world held its breath as the unprecedented separation of adult brains began. The attempt failed; both sisters bled to death; people everywhere were saddened.

We now step into the world of neuroethics. This is the field of philosophy that discusses the rights and wrongs of the treatment of, or enhancement of, the human brain.

Were these patients capable of making an informed choice? Nobody disputes the sisters' mental competency to stake their lives on their hopes for individuality. Doctors, not to mention pre-operation media interviewers, made them aware of the 50-50 chance of death. Most of us would hesitate to challenge their right to take that risk.

Was the medical team acting ethically, putting the patients' interests first, or was it influenced by the humanitarian prospect of the advancement of specific knowledge about the brain — or by the attraction of the world fame and professional prestige that would follow a high achievement?

The available evidence is that the doctors thought there was a reasonable chance for success. When added to the sisters' strong desire to live free of a connection they found unbearable, that seems to tip the balance to a conclusion that the operation was right to do, even though it could and did end in tragedy.

Not just neurosurgeons but other brain scientists are thinking long and hard about the morality (right or wrong) and the ethics (fair or unfair) of what such breakthroughs as genomics, molecular imaging and pharmaceuticals will make it possible for them to do.

In the treatment or cure of brain disease or disability, the public tends to support neuroscience's needs for closely controlled and informed experimentation. But in the enhancement of the brain's ability to learn or remember, or to be cheerful at home or attentive in school, many of the scientists are not so quick to embrace mood-manipulating drugs or a mindless race to enhance the mind.

The brain's ethical sense may run deeper than we think. "The essence of ethical behavior," writes the neuroscientist Antonio Damasio in "Looking for Spinoza," his newest book, "does not begin with humans." Ravens and vampire bats "can detect cheaters among the food gatherers in their group and punish them accordingly." Though human altruism is much further evolved, in one experiment "monkeys abstained from pulling a chain that would deliver food to them if pulling the chain caused another monkey to receive an electric shock."

Damasio does not believe that there is a gene for ethical behavior or that we are likely to find a moral center in the brain. But we may one day understand the "natural and automatic devices of homeostasis" — the brain's system that balances appetites and controls emotions, much as a constitution and a system of laws regulates and governs a nation.

This week's sad loss of the conjoined twins in Singapore should remind us of more than the risks inherent in the most modern neurosurgery.

Something mysterious is going on in the minds of brain scientists as they debate going beyond the cure of disease to the possibilities of meddling with memory or implanting a happy demeanor. What drives them to grapple with the ethics of the manipulation or the equalization of the powers of the mind?

Maybe the human brain has a self-defense mechanism that causes brain scientists to pause before they improve on the healthy brain. Would we feel guilty about discovering the chemistry of conscience?

[cyborgdreamer]

I would go through the operation but I'd leave instructions to have myself frozen if it failed.