Re A (Children) (Conjoined Twins: Surgical Separation)
Separating conjoined twins, knowing that one would die, was lawful under the doctrine of necessity, in exceptional circumstances.
Facts
Jodie and Mary were conjoined twins, joined at the lower abdomen. Mary's heart and lungs did not function properly, and she was kept alive only because Jodie's heart and lungs circulated oxygenated blood through both their bodies. Doctors said that, without an operation to separate them, both would die within months, but that if they were separated, Jodie would probably live a normal life, while Mary would inevitably die. The parents, who were devout Roman Catholics, refused to consent. The hospital applied for a declaration that the operation would be lawful.
Legal principle
The Court of Appeal granted the declaration. All three judges held that the operation would be lawful, though for different reasons. Brooke LJ said that the defence of necessity applied, because the operation was needed to avoid inevitable and irreparable evil, no more would be done than was reasonably necessary for the purpose to be achieved, and the evil inflicted was not disproportionate to the evil avoided. He distinguished Dudley and Stephens, because Mary was not chosen to die: she was, by nature, designated for death, as she was killing her twin. The court emphasised that its decision was confined to the unique facts of the case. Jodie survived the operation, and Mary died.
Related cases on defences: self defence, duress and necessity
- Beckford v The Queen [1988] AC 130
- R (Collins) v Secretary of State for Justice [2016] EWHC 33 (Admin), [2016] QB 862
- R v Bowen [1997] 1 WLR 372
- R v Clegg [1995] 1 AC 482
- R v Conway [1989] QB 290
- R v Dudley and Stephens (1884) 14 QBD 273
- R v Gotts [1992] 2 AC 412
- R v Graham [1982] 1 WLR 294
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This summary is for study and revision and is not legal advice. Although our case summaries are checked for accuracy, we do not guarantee that they are free from errors or omissions. Always read the full judgment for the court's reasoning.
