View Poll Results: Should the doctors have operated on the Iranian twins, Ladan and Laleh Bijani?

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Thread: Should the doctors have operated on the Iranian twins, Ladan and Laleh Bijani?

  1. #1

    Default Should the doctors have operated on the Iranian twins, Ladan and Laleh Bijani?

    Should the doctors have operated on the Iranian twins, Ladan and Laleh Bijani? I would say yes because it was their wish...
    Last edited by amethyst; 9th July 2003 at 06:28 PM.

  2. #2
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    Nobody wish to see the operation end in tragedy.

    Let's look at it this way. The twins are two seperate physical beings. They are fused at the head but they do not share a set of internal organs. As long as both are healthy, there is no immediate need to seperate them. But what happen when they grow old and one of them die first? What will happen to the surviving twin?

    The question still needs to be answered.

  3. #3

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    Even if they are separated, they may become vegetables...

    Perhaps death was the only way out for them to be separated....

    Hope they are happy in heaven now they are separated.

  4. #4
    ClubSNAP Idol Adam Goi's Avatar
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    For me, the case is closed, period.

  5. #5
    Senior Member wormz777's Avatar
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    For me, I don't think we should have any doubts about the doctors' capability.

    It is very disrespectful imho.

  6. #6

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    OK, I'll say it:

    No.

  7. #7
    psyche
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    I have mixed feelings about this...

    Was just discussing with a few friends today. The doc's defensive reply was the twins so much wanted to be separated and they had said even at all costs. But, but... I was thinking. Isn't this something like euthanasia or mercy killing (hope spelling's correct)? In such a case, patients or their closed ones willingly request to have their life support system removed to end their suffering. In fact, in this case, they know it's a 99.99% gone case except for a miracle. But how come it's illegal?

    I didn't know until recently a German doc back in 1996 rejected the operation totally knowing that it was too difficult an operation to risk. So what were our docs hoping for?

    The twins came to Sing bcos they had heard of a successful operation done here back in 2001 on a Siamese twins. But that doesn't mean it will be successful for ALL other cases right? Should not the doc weigh upon the options of giving the Iranian twins a quality of life for the remaining months or years despite their protests or wants, and an operation they very well knew was extremely high in risk?

    On the other hand, I have no doubt in the surgeons' and other medical care workers' sincerity and expertise in the operation.
    If the operation had gone thru, they would have been seen as saints to decide on the operation. But as is always the case, when it is a failure, old ethical questions will resurface.

    I guess the best way is to mourn for them now and just move on...
    Last edited by psyche; 9th July 2003 at 10:04 PM.

  8. #8

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    Originally posted by StreetShooter
    OK, I'll say it:

    No.
    care to explain your opinion more ? I'm interested to hear from someone who is more knowledgable on this than the average joe.

  9. #9

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    One of the guiding principles in medical practice is primum non nocere - "first do no harm". I am of the opinion that this principle was violated in this particular instance.

    While I am not a neurosurgeon and therefore not familiar with the risks involved, it remains a fact that the German neurosurgeons refused to go through with the surgery because the risk was considered too great. In this case there are no mortality rates to cite, simply because it's the first attempt to ever separate adult conjoined twins, if I am not wrong. Well, OK, now you can say that the mortality rate for this operation is 100%.

    It can be argued that there's a first time for everything. After all, if Christian Barnard had not performed that first heart transplant in 1967 (the patient survived 18 days), the tens of thousands of people who have had the operation since then would not have benefited.

    But this is a different kettle of fish. The original heart transplant recipient would have died within a very short time, so in real terms, transplant or no transplant did not make much difference. Here we have two laughing talking human beings undergoing a VERY risky operation for what are essentially social and not medical reasons. Remember, the finding of increased blood pressure in the brain was made AFTER the decision to go ahead, and was not the main reason for doing so. Also, heart failure is a HUGE problem, and the development of a technique to perform heart transplants would and did benefit many many people. On the other hand, one must wonder at how useful to medical science the separation of conjoined twins would be. I mean, how many of them are there in the world?

    The scale of the tragedy did not strike me until I saw the video of their lives pieced together on TV. It made them human beings, rather than just a medical curiosity to me. Alas, the only reason I got to see it was because the operation had failed.

    As a doctor, sometimes it is your responsibility to say "No" to your patients. I believe this should have been one of those times. Ultimately it's a subjective opinion, and each doctor has to come to his own conclusion with each case. I think I have said enough.

    The last bit below was posted on another forum, and reflects my initial thoughts:

    "Anyone remember watching the movie "The Unbearable Lightness of Being."? I remember the last part very well. I think everyone died in a car crash, but that was not shown. What was shown was everyone drunk and happy and laughing and singing in the car as it is driven along, and then the scene whites out slowly into oblivion.

    That must be, in a way, how it was with the twins. I think there's probably no better way to go, than to be put to sleep with the expectation that you're finally gonna wake up as two separate individuals, something you've dreamed about literally all your lives.

    In fact, this may be better than waking up to the reality that one or both of you are gone, or has become a human vegetable.

    Life is but a shadow of reality, anyway."

  10. #10

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    well, I'm glad there're doctors that still thinks this way!...

    ..NuTs..

    Originally posted by StreetShooter
    One of the guiding principles in medical practice is primum non nocere - "first do no harm". I am of the opinion that this principle was violated in this particular instance.
    ....
    ....

    As a doctor, sometimes it is your responsibility to say "No" to your patients. I believe this should have been one of those times. Ultimately it's a subjective opinion, and each doctor has to come to his own conclusion with each case. I think I have said enough.

  11. #11

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    we must also remember that it was utmost wish to be separated and docters have told them about the risks that are involved in this operation. It was a choice that they made so let's just respect it... They were separated for 90 minutes of their life. Although it din turn out the way we wanted but for them, they might have been satisfied with it....
    The docters did what they could and acted according to the wishes of them... We should just respect the twins' wishes and remember their optimism and courage...

    At least, that's what I think.... just my 2 cents

  12. #12

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    we all have no idea what it is like to join ur brain with another person. u have to eat/sleep/play/study/work etc etc with another person. their wish is to be separated & lead their own life at all circumstances meaning they will rather die if they can't be separated.

  13. #13
    psyche
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    Originally posted by amethyst
    we all have no idea what it is like to join ur brain with another person. u have to eat/sleep/play/study/work etc etc with another person. their wish is to be separated & lead their own life at all circumstances meaning they will rather die if they can't be separated.
    Yes true but so is it difficult for us to understand the immense pain of those who are dying of terminal illnesses like cancer and they request to die. It's illegal in many countries and open to many ethical medical/religious issues.

    But my heart goes out to the people of Iran and the loved ones of the twins. Indeed they were courageous and will always be remembered for touching the lives of people around them.

  14. #14

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    It's a slippery slope. There are many terminally ill patients whose greatest wish is to die as soon as possible. I'm sure we all know what I am talking about.

  15. #15
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    I think the comparison of this operation with euthanasia is totally inappropriate.

    Euthanasia means helping terminally ill people to end their lives painlessly.

    For this case, the procedure was done so that the twins can live life the way they have always wanted.

    It was meant to give a new life (or 2 new lives) and not to end one.

  16. #16

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    The same dilemma applies to both situations: Should doctors always agree to the wishes of the patient, if these wishes are not in the best interest of the patient? In both cases, a viable option would be: "When in doubt, do nothing."

  17. #17

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    I think it is not fair for us to judge here...the doctors have tried their best...if the operation has been successful, will u still say they shouldn't? be fair to them...
    DR KOH KHO KING

  18. #18
    psyche
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    Originally posted by Belleforte
    I think the comparison of this operation with euthanasia is totally inappropriate.

    Euthanasia means helping terminally ill people to end their lives painlessly.

    For this case, the procedure was done so that the twins can live life the way they have always wanted.

    It was meant to give a new life (or 2 new lives) and not to end one.
    That sounds very nicely put and rosy but even at the extremely high risks involved save for a miracle?

    In Laleh and Ladan's case, the doctors did their duty of explaining the extremely high risks involved that could realistically lead the death of one of them if not both (unfortunately this is the case). Even if they could have been separated, what would have been the quality of life they could lead? Would there be more complications amounting to more discomfort and inconveniences than when there were joined together?

    But they insisted the doctors go ahead at ALL costs, including death, which is likely in the medical experts' opinion. So I draw parallels with the case of euthanasia in this sense, though I know they are not directly related.
    Last edited by psyche; 10th July 2003 at 11:20 AM.

  19. #19
    psyche
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    Originally posted by Kho King
    I think it is not fair for us to judge here...the doctors have tried their best...if the operation has been successful, will u still say they shouldn't? be fair to them...
    Who u referring this to? I think no one here is blaming the doctors... WE are just discussing the ethical issues... no absolute right or wrong answers.

    On the doctors' and nurses part, I truly salute them. I can imagine it's an extremely challenging operation, a world's first?, and it's certainly not easy to see whatever little hope you have on your patients dashed in an unsuccessful attempt.

  20. #20

    Default Re: Should the doctors have operated on the Iranian twins, Ladan and Laleh Bijani?

    Originally posted by amethyst
    Should the doctors have operated on the Iranian twins, Ladan and Laleh Bijani? I would say yes because it was their wish...
    well their wish is fulfilled liao lor

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