Spotlight: The conjoined twins case

The Attards, parents of conjoined twins, would not give their consent to separation surgery that would kill Mary, the weaker twin. They saw their daughters as equals and could not sanction medical treatment that would kill one of them. However, separation was vital if Jodie, the stronger twin, was to survive.
An application was made for the inherent jurisdiction of the court to be invoked.
The subsequent hearing culminated in the decision of Mr Justice Johnson on 25 August 2000 in the Family Division of the High Court, which confirmed that the doctors could proceed with the separation surgery.
The parents appealed against the decision, on the grounds that:
- Separation of the twins would not be in Mary's best interest and there was no real evidence to support the judge's decision at first instance that, without separation, prolonging Mary's life would be "to her disadvantage".
- Separation of the twins would not be in Jodie's best interest. They argued that the judge erred in finding that: "For Jodie, separation means the expectation of a normal life." They said that he gave insufficient weight to the medical and other problems that Jodie would face if she survived such a separation procedure.
- Even if separation would be in the best interest of one, or both, twins, it would be illegal, as the operation required to separate them could only properly be characterised as a positive act, with no therapeutic purpose for Mary, that would terminate Mary's life.
In September 2000, the Court of Appeal upheld the decision of Judge Johnson and the twins were separated in November. As predicted Mary died, while Jodie lived and returned to Malta with her parents.
Pannone's head of clinical negligence John Kitchingman, who led the team, says: "It was a completely intractable dilemma for the parents and for the doctors, and for the courts it was a genuine ethical dilemma, for which there was no answer that would satisfy even half the people." He adds: "It was the most interesting case I've ever been involved with in terms of the breadth of legal issues involved, right from family law, criminal law, media law and human rights law, dealing with the most fundamental human right of all - the right to life."
Simon Taylor of Cloisters, instructed by Pannone, acted for the parents; David Harris QC of India Buildings Chambers and Andrew Hockton of 6 Pump Court instructed by the Official Solicitor, acted for Mary; Adrian Whitfield QC and Huw Lloyd, both of 3 Serjeants' Inn, were instructed by Hempsons for Central Manchester Area NHS Trust; Judith Parker QC of One King's Bench Walk, Tim Owen QC of Matrix Chambers and Deborah Eaton, acting for Jodie, were instructed by Bindman & Partners.