title: Conjoined Twins: Philosophical Problems and Ethical Challenges.
abstract: We examine the philosophical and ethical issues associated with conjoined twins and their surgical separation. In cases in which there is an extensive sharing of organs, but nevertheless two distinguishable functioning brains, there are a number of philosophical and ethical challenges. This is because such conjoined twins: 1. give rise to puzzles concerning our identity, about whether we are identical to something psychological or biological; 2. force us to decide whether what matters from an ethical point of view is the biological life of our organisms or the existence of our consciousness or mind; 3. raise questions concerning when, if ever, it is morally acceptable to sacrifice one of us to save another; 4. force us to reflect on the conditions for ownership of organs and the justification of removal of organs for transplantation which causes the death of the donor; 5. raise questions about who should take decisions about life-risking treatments when this cannot be decided by patients themselves. We examine and suggest answers to these questions.
authors.affiliation: University of Oxford, Oxford, UK University of Oxford, Oxford, UK julian.savulescu@philosophy.ox.ac.uk.
authors.forename: Julian
authors.initials: J
authors.lastname: Savulescu
authors.affiliation: University of Oxford, Oxford, UK University of Oxford, Oxford, UK.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Persson
mesh_terms: D026689:Ethical Analysis; D004992:Ethics, Medical; D006801:Humans; D009014:Morals; D010686:Philosophy, Medical; D013514:Surgical Procedures, Operative / Q000941:ethics*; D014428:Twins, Conjoined; D026712:Value of Life
keywords: conjoined twins; doctrine of the double effect; organ transplantation; personal identity; value of life