Opinion: Should we have separated conjoined twins, knowing one would die?

Doctors work hard to save lives. But what if saving one life might mean ending another?

Several colleagues and I at the MassGeneral Hospital for Children recently faced that chilling and ethically daunting question. It started with a phone call on a Friday afternoon before a long weekend. As chair of our pediatric ethics committee, I’m used to calls from colleagues posing questions. But this one was different. Our hospital was being asked to evaluate 22-month-old conjoined twins to see if we could separate them.

My mind immediately turned to cases typically portrayed in the media. A massive team assembles and, after extensive planning and preparation, performs a grueling day or two of separation surgery. The children have some postoperative challenges but eventually leave the hospital healthy, a testament