Should we separate conjoined twins?

Singapore neurosurgeon Dr Keith Goh has undertaken several controversial operations to separate conjoined twins. In a recent interview, he made some philosophically interesting remarks.

Source: The Sunday Times, 26/4/9, p.35
Headline: Surgeon takes flak in his stride
Writer: Nur Dianah Suhaimi

Quote1:
He [Dr Goh] does not think he should walk away from a tough medical case out of fear. "Everyone is entitled to his or her opinion. In life, we can't win 100 percent approval all the time. [a] But I always believe that we should give patients the benefit of the doubt and give them a thorough evaluation before saying no. [b] If these were my children, I would want them to be helped, not turned away without being given a chance [c]," he said.

Comment1:
[a] How much approval should we seek? Whose approval should we seek?
[b] Do patients lie? Is "evaluation" to verify patients' claims?
[c] Can we always generalise from a personal preference?

Quote2:
Having observed three pairs of conjoined twins, he is convinced their lives are far from normal. "It is a freakish life. People laugh at you, ridicule you. Plus it is so uncomfortable. Some of them become objects of fear in their society. Life like that is not life at all."

Comment2:
Do these conditions separately or jointly amount to "not life at all"? Is "not life at all" therefore deserving of possibly fatal surgery?

Quote3:
However, he stressed that in the end, the decision whether or not to go ahead with the surgery is not his to make alone. In the previous operations, while the ultimate decision lay with the patients and their parents, there were also many other doctors who had given the go-ahead.

Comment3:
Who should be involved in making the decision, and in what degrees?

Quote4:
He compared himself to Dr Christian Bernard, who pioneered heart transplants. Even though many of his patients died soon after their operations initially, he had persevered. Heart transplants have now become routine in medical practice. "In the course of medical history, many doctors have tried on different cases where the initial results have failed. But we must be brave and cannot give up," said Dr Goh.

Comment4:
Here we have an argument by analogy. Here's the analogue: Dr Bernard had initial failures, but persevered, and now heart transplants are routine. So also will be the case with conjoined twins.

Analogies work on similarity, and are derailed by serious dissimilarities. One such that I can think of is that hearts are straightforwardedly connected to the other body parts by arteries and veins; whereas conjoined twins are connected to each other in far more complex ways.

Also, surely medical history offers also many cases of procedures being abandoned after serious failures. The offered generality may not be general.

Quote5:
But he maintains that he is not too disturbed by what others may think. "At the end of the day, what matters most is that I have been true to my principles and am able to sleep well at night with my decisions."

Comment5:
If every individual lived true only to his or her principles, would society still be possible or viable?

END