The conjoined twins and the limits of rationality in applied ethics.
In this article I consider the case of the surgical separation of conjoined twins resulting in the immediate and predictable death of the weaker one. The case was submitted to English law by the hospital, and the operation permitted against the parents' wishes. I consider the relationship between the legal decision and the moral reasons adduced in its support, reasons gaining their force against the framework of much mainstream normative ethical theory. I argue that in a few morally dilemmatic situations, such a legalistic-theoretical approach cannot plausibly accommodate certain irreducible and ineliminable features of the ethical experience of any concrete individual implicated in the situation, and that this failure partly undermines its self-appointed role of guiding such an individual's conduct. For example, the problem as experienced by the judge and by the parents might not be the same problem at all, and some of their respective reasons may be mutually unintelligible or impotent. I certainly do not argue for a rejection of law or of moral theory; I merely challenge their implicit claim to comprehensiveness and their fixation with an idealised and putatively universal rationality modelled on converging scientific enquiry. Finally, I claim that at least in the twins' case there may be insufficient normative robustness to the conclusions reached, or indeed reachable, by the court in a situation where intuitions and moral reasons pull in fundamentally incommensurable directions; as such, there may be room for an acknowledgement of the spiritual, through a humble abstention from making a decision--which is not to be confused with deciding to do nothing.
Department of Humanities, University of Hertfordshire, Wall Hall, Aldenham, Watford, Hertfordshire WD2 8AT, UK. c.t.cowley@herts.ac.uk
Christopher
C
Cowley
D026688:Bioethical Issues; D003657:Decision Making / Q000941:ethics*; D034462:Dissent and Disputes; D026689:Ethical Analysis; D028781:Ethical Relativism; D028663:Ethical Theory; D006708:Homicide / Q000941:ethics; D006761:Hospitals; D006801:Humans; D007231:Infant, Newborn; D033222:Judicial Role; D009014:Morals; D010290:Parents; D029181:Spirituality; D016312:Treatment Refusal / Q000941:ethics; D014428:Twins, Conjoined / Q000601:surgery*; D006113:United Kingdom