Thesis: Based on Singer’s moral principle, the parents of conjoined twins, Mary and Jodie, have a moral obligation to have the twins surgically separated
 

    Mary and Jodie were born joined by the lower abdomen and share a heart and lungs. Their heads are at the opposite ends of their merged bodies and their legs emerge at right angles from each side. Mary is completely dependent on her sister Jodie’s blood to survive because she does not have a heart or lungs of her own. Doctors predict that if the twins remain joined together, the consequent strain placed on Jodie’s heart will result in the death of both the girls within six months. Doctors encourage the separation of the twins although this would result in the death of Mary, since she lacks the vital organs necessary to survive. Singer’s moral principle states that if it is in our power to prevent something bad from happening, without thereby sacrificing anything of comparable moral significance, then we ought to do it (Singer as cited in Geirsson & Holmgren, 2001). Based on this principle, I argue that Jodie and Mary’s parents have a moral obligation to have the twins separated.

    With regards to this issue, many people have utilitarian intuitions based on the argument that it is better to save one life than none at all. Because utilitarians are solely concerned with consequences, they argue that you are as equally culpable for inaction as for action. Therefore not separating the twins, and consequently allowing both to die is intrinsically the same as killing both of them (Tiffany, 2003). If the consequence of separating the twins is one death instead of two, this is a good thing. According to utilitarianism, an act is right to the extent that it brings about what is good, just as an act is wrong to the extent that it brings about what is bad. Hence, Singer argues that if it is in our power to promote good, then it is our duty to do so.  However, some may question whether it is morally acceptable to violate or use people to promote the greater good.
Kantian deontology argues that regardless of the overall consequences, certain acts are morally right and others are morally wrong. It is not justifiable to act any way one pleases, just because the overall results are good. Therefore the ends do not justify the means. Some actions are intrinsically wrong and we should not pursue them simply because the overall consequences are desirable. Kant’s second formulation of the categorical imperative states that we should act in such a way that we always treat humanity never merely as a means but always at the same time as an end (Geirsson & Holmgren, 2001).

    According to this imperative, human beings should be treated with respect and dignity at all times, and should never be used merely as a means. That is, a person should be treated as having intrinsic value, and not just as an instrument to achieve another end (Tiffany, 2003). Therefore, with regards to this case, Kantians would argue that although separating the twins would bring about the greatest overall good (by saving one life instead of none), it is wrong to separate the twins because it involves using Mary as a mere means to save the life of Jodie.
Singer addresses this objection in the latter part of his moral principle. He says, “as long as we do not sacrifice anything of comparable moral significance, then we ought to do it” (Singer as cited in Geirsson & Holmgren, 2001). The question now is, by separating the twins with the intention of saving one life, are we sacrificing anything of comparable moral significance? That is, are we sacrificing anything that is of equal moral worth to a human life?

    Legal experts debate whether Mary is actually a living human being because she does not have a heart or lungs. On the other hand, she does have a separate and functioning brain, so some conclude that she is a living human being. However, it is clear that Mary would not be alive is she was not conjoined to her sister Jodie, and has no chance of continuing to live whether she remains joined to her sister or not, therefore it is possible to regard Jodie as the only living human being of the two. For that reason Mary is a not unlike a growth, dependent on the heart and lungs of Jodie, without which she would not live. Therefore, Mary cannot be considered to be a living human being.

    To expand this point further, were we to consider “Mary” a non-living entity, then what has up until now been referred to as “the twins”, is in fact a single living organism, with a life-threatening disability. Following this line of reasoning, “Mary” is nothing more than a hindrance to the survival of the organism. Thus the removal of this hindrance is analogous to any life-saving operation, for example, the removal of a cancerous tumor. Therefore, one can argue that separating the twins would not mean sacrificing anything of comparable moral significance.

    In saying this, I deduce that as long as the “twins” remain conjoined, then “Jodie” will die, and this is a bad thing. I also assume that it is within the power of the doctors to prevent that death, without as a result, sacrificing anything of equal moral significance.  If these two assumptions and Singer’s moral principle are correct, then the parents have a moral obligation to have the twins separated.  The argument for an obligation to have the twins separated, if illustrated in a more formal way, would look like this:

P1: If we can prevent something bad without thereby sacrificing anything of comparable moral significance, then we ought to do it.
P2: The death of a living human being is bad.
P3: It is in our power to prevent the death of a living human being without sacrificing anything of comparable moral significance
Conclusion: We ought to prevent the death of a living human being.

Consequently, the utilitarian and Kantian would agree that separating the twins is the morally correct thing to do. The Utilitarian would argue that it was always the right thing to do, because the separation would have brought about the greatest overall good. However, until the Kantian agrees that “Mary” is not a living human being, they would argue that it is morally wrong to separate them. However, if we consider Jodie as one individual organism with a life-threatening disability, the Kantian cannot object that it is wrong to have the disability removed.

    In conclusion, according to Singer’s principle, if it is in our power to prevent something bad from happening, without thereby sacrificing anything of comparable moral significance, then we ought to do it. In this case, it is in the power of the doctors to save the life of Jodie, without as a consequence sacrificing anything of equal moral worth.  For that reason they the parents have a moral obligation to have the “twins” separated.

References

Geirsson, H. & Holmgren, M. R. (2001). Ethical Theory: A Concise Anthology.  Peterborough, Ontario, Canada: Broadview Press Ltd.

Singer, Peter. “Rich and Poor”. In H. Geirsson & M. R. Holmgren (Eds) Ethical Theory: A Concise Anthology. (pp. 320-339). Peterborough, Ontario, Canada:  Broadview Press Ltd.

Tiffany, E. (2003). Lecture Notes. Philosophy 120: Moral Thinking. Simon FraservUniversity.