English Law. Court of Appeal Authorizes Surgical Separation of Conjoined Twins Although Procedure Will Kill One Twin. Re A (Children) (Conjoined Twins: Surgical Separation), [2000] 3 F. C. R. 577 (C. A.)

2001 ◽  
Vol 114 (6) ◽  
pp. 1800
Keyword(s):  
Conjoined Twins ◽  
English Law ◽  
Court Of Appeal ◽  
Surgical Separation

Necessity as a Justification in Re A (Children)

2004 ◽  
Vol 68 (5) ◽  
pp. 440-450 ◽  
Author(s):  
Itzhak Kugler
Keyword(s):  
Criminal Law ◽  
Conjoined Twins ◽  
English Law ◽  
Court Of Appeal

In criminal law theory, it is common to distinguish between the defence of necessity as a justification and the defence of necessity as an excuse. However, it is sometimes said that English law does not clearly distinguish between justification and excuse. In Re A (Children) the Court of Appeal permitted the separation of conjoined twins although the separation would lead to the immediate death of one of the twins. In his judgment, Brooke LJ invoked the defence of necessity and appears to be ready to base his decision on necessity as an excuse. It is, however, submitted in this article that Brooke LJ's decision should be interpreted as having been based on necessity as a justification. Consequently, it cannot be said any longer that English law does not distinguish between justification and excuse.

Square Pegs in Round Holes: The Dilemma of Conjoined Twins and Individual Rights

2001 ◽  
Vol 10 (4) ◽  
pp. 459-482 ◽  
Author(s):  
Vanessa E. Munro
Keyword(s):  
Conjoined Twins ◽  
Individual Rights ◽  
English Court ◽  
Legal Entity ◽  
Rights Discourse ◽  
Court Of Appeal ◽  
Surgical Separation

The judgment in the English Court of Appeal case of Re A ( Conjoined Twins: Surgical Separation) highlights forcefully the highly individualistic and abstract assumptions that commonly shape the deployment of rights discourse in liberal legal adjudication. Forced by the all-or-nothing nature of this discourse into a dilemma between perceiving of the twins as separate right-bearers or perceiving of the stronger twin, Jodie, as the singular right-bearer and of Mary, her weaker sibling, as a non-legal entity, the court chose the former option.

RESOLVING THE UNRESOLVABLE: THE CASE OF THE CONJOINED TWINS

2001 ◽  
Vol 60 (1) ◽  
pp. 1-58
Author(s):  
Andrew Bainham
Keyword(s):  
Heart Failure ◽  
Monozygotic Twins ◽  
Conjoined Twins ◽  
The Other ◽  
Successful Operation ◽  
The Common ◽  
Roman Catholics ◽  
Court Of Appeal ◽  
Surgical Separation ◽  
Reasonable Prospect

IN Re A (Children) (Conjoined Twins: Surgical Separation) [2000] 4 All E.R. 961 the Court of Appeal faced the impossible dilemma of having to decide whether to authorise a complex operation to separate Jodie and Mary, ischiopagus conjoined twins (joined at the pelvis). The condition of the babies was extremely rare, it being estimated that only about once in 100,000 births will monozygotic twins fail to separate completely. Even then, ischiopagus twins account for only about six per cent. of the total instances of conjoined twins. Another very rare peculiarity of the case was the certainty that the operation, if sanctioned, would quickly and inevitably bring about the death of the weaker twin, Mary. This was because the twins shared a common aorta. Mary’s own heart and lungs were severely deficient and incapable of oxygenating and pumping blood through her body. Her life was thus sustained only by the common artery and separation would necessarily involve clamping and severing this. It was equally clear that the effect of failing to attempt the separation would be the inevitable death of both twins within three to six months. The cause of death would be heart failure since Jodie’s heart would sooner or later fail. The parents, devout Roman Catholics, opposed the operation, believing that in God’s eyes the twins were equal and that one could not morally be sacrificed to save the other. The hospital took a different view. It believed that a successful operation could be performed which could give the stronger twin, Jodie, a reasonable prospect of a worthwhile life.

scholarly journals Thoracopagus conjoined twin - a case report

1970 ◽  
Vol 10 (4) ◽  
pp. 289-292
Author(s):  
F Sharmin ◽  
F Begum ◽  
T Parveen ◽  
SF Khatun ◽  
W Fatima
Keyword(s):  
Case Report ◽  
Prenatal Diagnosis ◽  
Caesarean Section ◽  
Early Diagnosis ◽  
Conjoined Twins ◽  
Separation Procedure ◽  
Review Of The Literature ◽  
Surgical Separation

A patient at her 38+ wks of pregnancy as a ultrasonographically diagnosed case of conjoined twin admitted in our department with ruptured membrane. Two live female babies joined at the chest were delivered by caesarean section. The parents refused a separation operation and the mother and the babies were discharged from hospital at 6th post natal day. A review of the literature suggests that early diagnosis by a combination of ultrasound and MRI is essential for management as it provides prognosis for viability and process of surgical separation and also the opportunity for early counseling of parents and termination if indicated. Key world: Conjoined twins; thoracopagus; prenatal diagnosis; separation procedure DOI: http://dx.doi.org/10.3329/bjms.v10i4.9504 BJMS 2011; 10 (4): 289-292

Conjoined Twins with Thoracoabdominopagus Anomaly in the Third Trimester

2014 ◽  
Vol 6 (3) ◽  
pp. 191-194
Author(s):  
G Saranya ◽  
Jaya Vijayaraghavan ◽  
Bhuvana LNU ◽  
Sheela LNU
Keyword(s):  
South Asian ◽  
Cardiopulmonary Arrest ◽  
Conjoined Twins ◽  
Rare Occurrence ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Third Trimester ◽  
Monochorionic Twins ◽  
The Third ◽  
Surgical Separation

ABSTRACT Conjoined twinning is rare; occurrence is about 1% of monochorionic twins. Here, we report a case of 26-year-old multigravida with 29 weeks pregnancy with conjoined twinsthoracoabdominopagus. Two live female babies joined at the chest and abdomen were delivered by cesarean section. The parents refused a separation operation and despite resuscitation the twins died of cardiopulmonary arrest after 16 hours. A review of the literature suggests that early diagnosis by a combination of ultrasound and magnetic resonance imaging is essential for predicting prognosis, management and success of surgical separation. It offers an opportunity for early counseling for parents and option for termination. How to cite this article Saranya G, Vijayaraghavan J, Bhuvana, Sheela. Conjoined Twins with Thoracoabdominopagus Anomaly in the Third Trimester. J South Asian Feder Obst Gynae 2014;6(3):191-194.

scholarly journals Queering Judgment

2017 ◽  
Vol 81 (5) ◽  
pp. 417-435 ◽  
Author(s):  
Alex Sharpe
Keyword(s):  
Gender Identity ◽  
Sexual Offence ◽  
Identity Fraud ◽  
Appeal Decision ◽  
English Law ◽  
And Gender ◽  
Court Of Appeal

This article is a response to a series of recent successful sexual offence prosecutions brought against transgender and other gender non-conforming people for gender identity fraud, and specifically to Leveson LJ’s judgment in the Court of Appeal decision of R v McNally. The decision is now the leading authority on sexual fraud generally, and gender identity fraud specifically, under English law. The response will take the form of an academic judgment, in this instance a dissenting or counter-judgment. The article will (i) present the facts of the case, (ii) provide some detail regarding the developing jurisprudence of the courts regarding sexual fraud, (iii) preface the counter-judgment with an explanation of why an exercise in academic judgement-writing is valuable, (iv) consider a queer approach to law, and detail some queer principles around which the counter-judgment will be organised and (v) present the counter-judgment, highlighting not only that McNally could have been decided differently, but that it ought to have been decided differently.

scholarly journals The role of rapid tissue expansion in separating xipho-omphalopagus conjoined twins in Vietnam

2021 ◽  
Vol 48 (4) ◽  
pp. 378-383
Author(s):  
Tran Thiet Son ◽  
Pham Thi Viet Dung ◽  
Ta Thi Hong Thuy ◽  
Vu Duy Kien ◽  
Nguyen Thanh Liem
Keyword(s):  
Tissue Expander ◽  
Tissue Expansion ◽  
Good Health ◽  
Conjoined Twins ◽  
Skin Area ◽  
Advanced Technique ◽  
Sterile Saline ◽  
Anterior Body ◽  
Surgical Separation

Conjoined twins are rare, and each set of conjoined twins has a unique conjoined anatomy. It is necessary to perform separation to increase the chance of patient survival. Tissue expansion is an advanced technique for providing sufficient soft tissue and skin for wound closure. We report the successful application of rapid tissue expansion in 10-month-old xipho-omphalopagus conjoined twins in Vietnam. A tissue expander was placed on the anterior body between the sternum and umbilicus with a baseline of 70 mL sterile saline (0.9% NaCl). The first injection into the tissue expander began on the 6th day after expander insertion, and injections continued every 2 days with approximately 30–70 mL per injection according to the expansion of the skin. The expander reached 335 mL after six injections and within 10 days. In order to prepare for surgical separation, expansion was completed on the 15th day after insertion. The expanded skin area was estimated to be 180 cm2, which was sufficient to cover both patients’ skin deficiencies. The twins presented for surgical separation 6 days following the completion of tissue expansion. Both babies were discharged in good health 1 month after separation.

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