The twins who stole our hearts

They knew each other and lived close to each other for twenty-nine years but they never looked at each other in the face. They were not enemies. On the contrary, they were sisters and the best of friends.

One of their ambitions in life was to look in each other's face. They were not asking for much. That's true in normal circumstances, but they were not living in normal circumstances.

We refer to Laleh and Ladan Bijani, the Iranian twins whose heads were joined, since birth, for 29 years.

In 1996, a team of German doctors refused the Bijanis' request to perform the surgery, saying separating them could be fatal. Nine years later an international team of 28 specialists and 100 assistants at Singapore's Raffles Hospital took up the challenge. The twins had spent months preparing for the operation and knew it was highly risky. Some experts gave the procedure a 50-50 chance of success.

The wish of Laleh and Ladan cost them their lives after an operation lasting over 50 hours.

Several comments were made. In line with this page's perspective we look at the ethical dimension. Archbishop Javier Lozano Barragan, president of the Pontifical Council for Health Care Workers, Redemptorist Fr Raphael Gallagher, professor of moral theology at Rome's Alphonsianum, and Mauro Cozzoli, professor of moral theology at the Lateran University, gave different evaluations of the operation.

The Vatican's top health official said surgeons in Singapore should not have attempted a risky operation, which proved fatal. "It was an error paid with the highest price possible, the price of two human lives," Archbishop Lozano said in an Italian newspaper interview on Wednesday.

"There was no moral obligation to do it. They were two persons who had lived together for 29 years... In the face of the high risk, the operation should not have been performed," he said. Archbishop Lozano said that without making "superficial condemnations" it was important to stress to doctors in such cases that the benefits must be very carefully weighed against the risks.

Fr Gallagher expressed a different opinion on Vatican Radio. He said he thought the operation did not create any ethical problems and noted that the sisters prepared for the operation, were aware of the risks and had entrusted themselves to some of the world's top surgeons.

"The medical team and the two women were aware of the possible consequences of the operation. So it doesn't seem to me that the choice to do the operation creates ethical problems," Fr Gallagher said, adding that he was saddened that the operation failed.

He commented: "I truly respect the courage of the two women and I think that their decision to do the operation was a very courageous moral choice."

Professor Cozzoli, like Fr Gallagher, also defended the justness of the operation. "It was of a healing nature, the condition of life of the two young women was clearly abnormal and, therefore, pathological."

According to the information available, Cozzoli said that "there was no intention to do away with life or to undertake an incautious and opportunist experiment, as it was intended to promote the autonomy and quality of life of two people severely incapacitated by a malformation."

During the past days these twins stole our hearts. They showed such courage and determination. We followed their progress and cried at the sad news but their death was not in vain. Iranian President Mohammad Khatami was right to say that the twins had left the world a legacy of patience and tolerance.

Perhaps one of the most beautiful editorials written about the twins was that of The Times of London. It praised what it called the rare spirits of two women born disadvantaged, but who "refused to act that way".

"The Bijani sisters demanded a chance not just to live, but also to be individuals, and eventually to be alone," the paper said. "Even at their most terrified, heading into the operating room, the Bijani twins smiled. Doing so, they redefined dignity."