A Life Worth Living?

December 13, 2011

Political Theory


Krista (on left) and Tatiana (on right)

In British Columbia, Canada, there is a set of conjoined, craniopagus twins.  Krista and Tatiana are both 4 years old and conjoined at the head.  More specifically, Krista and Tatiana are linked at the thalamus, the part of the brain that is responsible for interpreting sensation, spatial sense, and motor signals.  Each twin has shown signs of being able to feel and see what the other twin is experiencing.  During her pregnancy, Felicia was presented with the option to terminate the pregnancy.  She chose not to and the twins were born through a C-section.  Amazingly, Krista and Tatiana both survived the birth and have been thriving ever since.  But as Krista and Tatiana grow older, it will become more and more difficult to live normal lives being conjoined at the head.  The question will soon arise: should they risk a separation surgery?  The problem is that surgery is extremely risky; there is a possibility that one or both of the twins could suffer paralysis or even death.  If they choose not to undergo surgery, they will forever live their lives in a compromised state.  Thus, staying together means that Krista and Tatiana would forfeit any semblance of privacy or independence.  Their lifestyles, careers, and love lives are only a few issues that will have to be negotiated with one another, never experiencing absolute freedom. 

Although forgoing the surgery would cause endless complications for the twins, I think that the potential consequences are too extreme to risk surgery.  The possibility of death makes the surgery an illogical choice.  The goal of surgery is to improve the eventual lives of the twins, but if either or both die then what is the point?  I also think that it is important to consider the possibility of emotional damage.  If one twin died but the other survived, I expect that this would be quite traumatic to the parents and the surviving twin.  The potential for improved living circumstances is not worth the risk of death.  Furthermore, there are ways to improve Krista and Tatiana’s lives without needing surgery.  John Rawls believed that everyone deserved an equal opportunity to succeed in life and proposed that the government should create institutions in society to help the disadvantaged.  Unfortunately, Krista and Tatiana are exceptionally hindered by their condition.  I would advocate that the government somehow accommodate the twins and create programs that can help equalize their disadvantages and others with similar disabilities.  Without such programs, Krista and Tatiana would absolutely not have as equal of opportunities as anyone else.  Hopefully with specific policies, Krista and Tatiana will be able to lead as normal lives as possible. 

What do you think?  Is it worth it?  Should the twins risk their lives in order to secure a normal life?  If they choose to have the surgery and one of the twins dies or is paralyzed, would it have been worth it?  If the government were to create such institutions, how would they be able create an equal opportunity for Krista and Tatiana and other conjoined twins? 

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8 Comments on “A Life Worth Living?”

  1. lkpeacock Says:

    I do not believe that the surgery would be worth it. Living conjoined to someone else for the rest of your life would be extremely difficult. Without freedom or privacy life could be very difficult and frustrating at some points, but if your health is compromised, how can you expect to have a better life? Choosing between the two seems like an impossible choice, but for them, maybe it isn’t. Maybe they have grown to appreciate each other and could never think of putting the other’s life at risk. I do not know all of the health risks of both situations, but it seems that sharing a life with someone else would be better than living a very medically challenging life.

    I think their case is very rare so and institution might not be established for twins conjoined at the thalamus, but maybe there could be a program for conjoined twins. They could teach them how to cope with their sibling that in inevitably around them. They could teach them ways to find privacy even when they are connected and ways to cope with anger if they ever get frustrated with one another. I think they have an extremely challenging life ahead of them either way and hopefully their family is extremely important and they learn ways to deal with their situation positively.

  2. ymsyed Says:

    At the end of the day, I think that this is a decision that Krista and Tatiana will have to come up with for themselves. The risks are obviously huge for everyone, and-at the end of the day-they are going to be the ones living with their decision.

    I think that this would be an absolutely horrible decision to have to make, for Krista, Tatiana, and their parents. I think a Rawlsian approach to this problem–one that I agree with–would be to put in even more money towards the research of such things so that people in such predicaments can be helped more. Unfortunately, with the economy in the condition that it is today, this probably not very realistic.

  3. ksoisson Says:

    It would be hard for the government to accomodate for this very rare case. How many cases do you hear of two people being attached? As far as if the risk of being separated is worth it, I think that lies in the hands of the twins. However, they are clearly not old enough to decide for themselves. They should be able to decide if they want to risk their lives in order to live a more normal one. The problem is that they are so young. That kind of decision must be made later in their lives. As you said, Rawls believed everyone deserved an equal opportunity, but it’s up to the twins to decide if it’s worth it.

  4. verlong Says:

    I think that the decision of whether or not it would be worth it to separate the twins should be a decision made by the twins themselves. Being an outsider, we have no idea what kind of a relationship the twins have, and whether or not they would even fathom splitting apart. There are many risks with separating (as you and the video have said). However, I went and looked up things on this subject before writing this comment, and found that it is much more common to survive the surgery than you would think. I even read something about a similar conjoined arrangement (they share brain tissues, etc.) where the twins survived the surgery. At the same time, many twins also died from the surgery or complications afterwards. Obviously the success of the surgery and chance of survival depends on many things, and it would be discussed many times before a final decision was made.

    At the same time, if they continued to be conjoined they are going to live incredibly difficult lives. There will be many complications from staying together, not to mention the emotional trauma from society. However, there are conjoined twins that live late into their lives. No matter what decision is made, they will most likely never live a “normal” day in their entire lives. I don’t think that the government could make an entire program based around them, as much as we’d all like them to. This happens too rarely for it to be seen as “worth it.” Although equality is something to strive for, I do not believe that any result associated with the twins could make their lives “equal” to those of “normal” people.

    Obviously I know basically nothing about this situation, and it is not up to me at all (thank goodness). I hope that whatever choice is made, everyone involved ends up living a happy and healthy life.

  5. nozomigg Says:

    This is a more than difficult situation, as is anything that comes to life-or-death. There are negative implications to whatever choice is made. The most obvious answer might be to let them choose for themselves.. but then the next question would be: when is the right age for them to do so? Allowing them to make such a risky decision too early may suffer the consequences of rash and immature decision making, but preventing that and forcing them to wait may allow the brain to morph into a point where surgery is impossible. However, not allowing them to undergo the surgery may result in them suffering numerous physiological problems – they don’t have to walk everywhere right now, for example. Once they do, their necks will suffer enormous amounts of strain, their backs will have to constantly be realigned, their sense of balance will have to change from it’s original state.

    Considering all this, however, I still don’t think they should undergo the surgery. I know this is a rare case, but I also know that this case isn’t unprecedented either. Many twins such as these two have been able to continue through their lives, and although it hasn’t been ideal, it’s been possible. Just because they live in a way that we haven’t seen much before and will never be able to understand doesn’t necessarily mean that they’re going to suffer traumatic emotional consequences from being like this. If the brain has been split in a way that doesn’t affect them medically, then I think the best route is to let them be.

  6. thelenj1 Says:

    This is an extremely interesting, yet sad situation. If I was the mom of these children I do not think I would be able to bare the decisions she is having to make. If the likelihood of them dying or suffering severe damage was very high or even somewhat high, I do not think I would risk the consequences of the surgery. I think I would leave them joined because it is not worth losing one or both of their lives. Growing up together though, I believe their lives will be very challenging. I do not really agree with Rawls’ theory because I believe is in impossible to achieve. A government could never even everyone off so know one was advantaged. There are too many different cases that the government would need to serve to and with the human populations as big as they are today this is not realistic. How could a government serve to the two girls in this situation so that they are as well of as the most well off are? There is no way to bring them up to any standard of society and it is not right to try and bring society down to this level.

  7. jkb34383 Says:

    Such a decision for surgery is definitely not for us to decide; as it will probably become a very difficult decision for the twins or the twins’ family. Krista and Tatiana were born with a very unfortunate situation and this somewhat furthers the point that equal opportunity can never be obtained. These twins will be facing many obstacles and disadvantages in their lives.If they want to have the same opportunities as some who does not have a disability, they are going to have to make sacrifices that may involve putting their own lives at risk. Equal opportunity is a concept that I do no see as plausible. No matter how you redistribute the wealth among classes, no matter how jobs you create, and no matter how well you improve school systems, there can always be cases such as Krista and Tatiana’s.

  8. albosco Says:

    Krista and Tatiana are under unusual circumstances, that not many people have ever experienced. It’s quite clear that their ability to obtain equal opportunities has been inhibited by their situation. I do think that it is important that everyone has equal opportunities, but what exactly could the government do for them? This is such a rare occurrence that doctors haven’t been able to perfect the surgery. However, I do understand that Krista and Tatiana’s family will be be under more stress then most parents would be and I guess the government could compensate for the extra care. However, that would cause problems for people with children that have disabilities. How much does the government do for them? Yes, it is incredibly unfortunate that these two girls are in such a dangerous situation, but there is only so much the government can be responsible.

    As for the surgery, I am not sure what I think would be the best decision. I don’t think anyone could say wether or not they would have the surgery unless it directly effected their life. The girls are so young now that they would not understand what terrible consequences could come from the surgery. I think that Krista and Tatianas parents should wait until the girls are old enough to make the decision for themselves. Either way, I could not imagine being in their shoes and having to make a decision like that.

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