Separation of Conjoined Twins 1689

The history of conjoined twins and the surgical attempts to separate them involve perplexing medical and ethical issues that challenge our everyday concepts of personhood. Philosopher Christine Overall writes: "Moreover, we humans do not merely inhabit our bodies like a pilot in a ship, a ghost in a machine, or a divine soul in an earthly wing. We are our bodies." Ethicists continue to ponder scenarios in which the risky separation of twins born conjoined is performed.

Conjoined twins (also known as Siamese twins) are identical twins whose bodies join while developing in the womb. The mechanisms of their formation continue to be investigated through fusion theory and the suggestion that the fertilized egg undergoes only a partial division. According to fusion theory, the fertilized egg splits to form two embryos that later fuse.

Conjoined twins may be joined at different parts of the body, such as across the chest, with the twins sharing a single heart, liver, or part of the digestive system. In another example, the twins may share a head with a single face but four ears and two bodies. Probably the most famous conjoined twins are Chang and Eng Bunker, who lived with a liver fused to their torsos. They married sisters in 1843; Chang subsequently had 10 children and Eng had 11. If born today, Chang and Eng could have been successfully separated.

Below, Chang and Eng Bunker with their wives and one of their children

In 1689, Swiss surgeon Johannes Fatio performed the first successful separation of twins conjoined at the abdomen. Interestingly, a successful attempt to separate conjoined twins was made in Constantinople in 945 after one of the children died, but the surviving child lived for only three days.

Modern surgical techniques and radiological scans allow more complex operations to be performed, but various ethical concerns remain. In 2000, conjoined twins were separated in Great Britain despite their parents' religious objections. Before the operation, it was certain that surgery would kill the weaker twin. However, if the surgeons had not operated, both would have died.

Description of the article image: Ectopagus (laterally conjoined) dicephalus dibrachius tripus twins from Human Monsters (1891–1893) by Barton Cooke Hirst (1861–1935) and George Arthur Piersol (1856–1924).

Historical figures mentioned in the article: Johannes Fatio (1649–1691), Chang Bunker (1811–1874), Eng Bunker (1811–1874)

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