Personhood and Separation

The following is the next installment in a series of posts which began with the piece, Half Guilty.

At the end of last year, media outlets around the world lit up with news of the birth of conjoined twins in Brazil. The boys, Jesus and Emanuel, exhibit dicephalic parapagus conjoining, the same union as Americans Brittany and Abigail Hensel. They differ in that the share only one set of vital organs. Doctors credit the Hensel twins’ dual set of organs with their success into adulthood. Questions of separation, as always, abound.

Whenever conjoined twins come along, it’s interesting to note how  journalist and doctors comment on their individuality. A few examples below:

“A Brazilian baby was born with two heads, named Jesus and Emanuel, but appears to be in good health, according to doctors.” — International Business Times

“Despite all the problems we have as a small interior hospital we managed to save both mother and baby, which was our aim.” — Hospital director Claudionor Assis de Vasconcelos

“They are being monitored by specialists to see how they develop.” — BBC News

In the first two quotes, the commentator refers to the twins in the singular. In the latter quote the writer uses the plural pronoun “they” to signify their duplicative personhood.

The teratologist Saint-Hilaire noted that conjoined twins were given separate names, indicating their individuality, as springing from the practice of baptizing children on their heads. A body with well-formed two heads was therefore baptized once on each head and each received a name.

As science and medicine evolved, so did our longevity. While most conjoined twins would die in infancy 100 years ago, with the advent of modern medicine and an appreciable understanding of conjoinment (Chang and Eng Bunker could have been easily separated), conjoined twins can survive well past infancy and into adulthood. This allows us to appreciate the separate personalities that conjoined twins take on as the grow older, giving credence to the argument that there are in fact two individuals present in one entangled body.

One could argue then that under this logic a person exhibiting multiple personality disorder should be granted personhood for every personality in their brain. Regardless of the fact that multiple personality disorder lacks the physical component of conjoinment, the difference lies in the fact that multiple personality disorder, at least in theory, is curable.

“But wait!” the skeptic shouts, “conjoined twins can be separated!” A brilliant segue indeed.

Simultaneously with the news of Jesus and Emmanuel’s births came the news of the possibility of separation.  “A lot of work is needed, in terms of scans and tests, before doctors will know if they can separate them or not, and just how organs and blood vessels are shared and linked. It takes quite a while before they can decide how feasible [separation] is.” — Patrick O’Brien, a spokesman for the UK’s Royal College of Obstetrician and Gynaecologists. Later, doctors would reveal that separating the twins is  not an option because they share a set of organs. Attempting to separate them would be to kill one if not both of them (see Jodie and Mary).

Days before the birth of Jesus and Emmanuel, Chilean conjoined twins Maria Paz and Maria Jose (pictured above) made their way into the news. When the girls were 10-months old, doctors assessed their conjoinment and determined that separation was feasible. The 20-hour surgery took place and doctors deemed it a success. A week later on December 18, 2011, the news dropped: “A 10-month-old girl who was surgically separated from her conjoined twin died Sunday after suffering general organ failure, said the director of a Chilean children’s hospital.”

Despite all the science, all the innovation, and all the careful planning, their success became a failure with the death of one of the twins. They “were so preoccupied with whether they could that they didn’t stop to think if they should.” Alice Dreger is a bio-ethicist who continues to ask the question: should we separate conjoined twins? When conjoined twins come along, doctors’ first instinct is to wonder if they can be separated to give them a better chance at a “normal life.”

The thinking goes that we want people to be able to live the most normal life possible and conjoinment stands inapposite to that goal. But Dreger rebuts this assertion; perhaps conjoinment is what’s normal for them. For all the risk and possible little reward (rendering one as less than the Platonic ideal, reducing mobility in both twins, risking death), why does science encourage dangerous separation procedures? Instead, why not reconsider normal and accept that perhaps their conjoinment, their entanglement is the norm for these twins. If they can live full lives together, why are we so eager to rip them apart?

For Jesus and Emmanuel, separation is not an option. But the fact that doctors talk in terms of separation indicates that there is more than one person contained in these conjoined twins’ body, for it always takes two to tango.

Via MSNBC and BBC News.

Conjoined Twins as Legal Actors (III)

The following is the next installment in a series of posts which began with the piece, Half Guilty.

“Their brains are recording signals from the other twin’s visual field,” [Dr. Douglas Cochrane] cautiously concluded. “One might be seeing what the other one is seeing.”

 

A twin may be the instigator, but singling out one for punishment often doesn’t work. “When one gets in trouble and you try to discipline her, the other one kicks in and starts defending her sister,” says [their mother, Felicia] Simms. “I’ve just gotten to the point where if they don’t change their attitude when you talk to them the first time they both go into time out. How do you not?” she asks. “It’s just come down to?.?.?.?you can’t discipline one without disciplining the other. It’s just impossible.”

From Macleans.

Additional coverage at the NY Times.

The Human Centipede (First Sequence)

Note the conjoined twin print behind our antagonist

2010’s gross-out, horror film The Human Centipede (First Sequence) came and went with more hype than anything else. Finally, it’s hit Netflix on-demand opening up the movie to a much wider audience, except for the squeamish of course. Some have praised it highly, others panned it without due diligence. Roger Ebert’s remarks certainly take the cake:

I am required to award stars to movies I review. This time, I refuse to do it. The star rating system is unsuited to this film. Is the movie good? Is it bad? Does it matter? It is what it is and occupies a world where the stars don’t shine.

In the film the token, creepy German Dr. Joseph Heiter, played by Dieter Laser, is a former surgeon who made his living separating conjoined twins. But his true passion in life lies in attaching autonomous creatures to form a more perfect organism.

Will he succeed in building Ethmostigmus rubripes sapiens? Yes.

Will the doctor be thwarted by our plucky young cast? Perhaps.

Will you be emotionally scarred forever? No doubt.

Do yourself a favor and treat yourself to the Siamese triplets proffered by this heartwarming film.

A Few More Conjoined Twin Hypotheticals

“Two-headed Janus — diprosopic parapagus conjoined twins”

These hypotheticals are additional thought experiments pushing on the law’s assumption that an actor is an individual. Each case considers how the law would treat dicephalic parapagus conjoined twins (like the Hensel twins) as presented in the earlier piece, Half Guilty.

Q: The twins birth a child: who is the mother?

A: Identical monozygotic twins (twins born from the same, divided egg) have the same DNA, although expressed differently. Because of this it can be hard to tell identical twins apart based on DNA. However, identical twins have distinct fingerprints and can be distinguished in this manner. Similarly, conjoined twins are formed through the partial splitting of an egg and have identical DNA. In this case, because they share genitalia and one set of reproductive organs, they are arguably both the mother. Furthermore, a DNA test to determine the mother would prove inclusive as each shares the offspring’s DNA.

Q: The twins become pregnant: what happens if one wants an abortion and wants to carry the fetus to term?

A: In In re Marriage of Witten, a case of frozen embryos, the former wife wanted to fertilize the embryos to make babies. Her former husband waned them destroyed. The court ruled that the embryos were to be kept frozen until an agreement was reached, putting the burden of the upkeep on the embryos on the party who didn’t want them defrosted, the husband. However,  in the case of the twins there is the issue of terminating potential life, beyond that of unfertilized embryos. Likely the court would enjoin an abortion to protect the rights of one twin and the potential life of the fetus. There are major due process concerns here.

Q: The twins want to marry (not each other): do they marry the same man or separate men?

A: These women are arguably two separate persons. Because of their individuality it would make sense to prohibit them from marrying the same man, as bigamy is illegal in all 50 states. However with shared genitalia, their physiology makes the bounds of traditional marriage an issue.  Note that Chang and Eng Bunker married separate women, sisters in fact, and sired nearly two dozen children between them. They were connected by a band of flesh at the abdomen and did not share genitalia. Obviously, genitalia has less to do with getting a marriage license and more to do with the wedding night.

Q: The twins are driving and are pulled over for speeding: who gets the ticket?

A: Because they have separate consciousnesses and each controls half the body, one twin controls the pedals and the other controls the turn signal while they both control the steering to drive a car. Arguably because it takes two of them to operate the automobile, both should be held liable for any traffic infractions.