Conjoined Twins, Cloning and Artificial Intelligence

Rosie and Ruby Formasa at 12 weeks are two ‘normal, smiling bubbly babies’. But they have already survived major surgery, just one day after their birth.
Conjoined at the abdomen at the level of the umbilicus, the girls shared an intestine. Pregnancy scans in the second trimester had identified that the twins were conjoined, but could not show exactly where until the birth was induced at 34 weeks.

Angela Formasa, the twins’ mother, said “ What they have done for my two girls is amazing. When I was pregnant they were saying that the survival chances were quite low”

The surgery to separate them and replumb their intestines was apparently successfully performed and they have the expectation of a normal life.

Conjoined twins raise difficult ethical dilemmas . They can be joined by a thin sliver of skin, at the abdomen, chest or even brain. They arise because of anomaly of human development.

Sometimes, a single embryo is formed by a single sperm and egg but splits early in development to form genetically identical clones: identical twins. These share the same set of genes. Thus they look identical and behave in similar ways. However, sometimes the embryo does not completely split into two clones – the split occurs later and the two twins share some body parts.

Sometimes one identical twin is encorporated into the body of the other.

From an ethical perspective, what matters is whether there are two functioning brains and thus two persons. Where twins are conjoined, it does not make sense to say that one twin owns the body or has a greater right to it. Both were derived from the same single embryo which split, partially, into 2.

When there are two brains, there are two persons. What should be done about the body parts?

The current case is the easiest. Where the twins can be separated with very high chance that both can a normal body, the consensus is that it is in their best interests to be separated and have their own body. Separation in these cases is always performed.

It is more difficult when the twins share vital organs that can’t easily be separated. One Indian pair, Saba and Farah, are 15 years old and have always been connected at the skull. They and their parents refuse surgery because it is “too risky.” They always want to be together. What these twins are looking for is not surgery, but social support because they live in poverty.

As the risks of surgery increase, stories like this show that conjoined twins can live and value life sharing one body or being connected.

The most difficult case is where one twin is unlikely to survive even if connected or separated, but the other twin would survive with separation. Sometimes the “weaker” twin is incorrectly described as a “parasite.” In the famous case of Jodie and Mary, doctors described Mary as “essentially a parasite” growing at Jodie’s expense.
In these cases, one person must be killed to save the life of the other. As I have argued [cite blog], this might be justified but it is strictly speaking, killing one person to save another.

Conjoined twins challenge our conceptions of who we are, the relationship of mind and body, and what is necessary for a good and worthwhile life. There is no doubt surgery has made stunning advances and many twins who could not be separated in the past can now, like the Formasa twins, be successfully and happily separated. But there will always be cases where conjoined identical twins raise profound ethical challenges.

Philosophers once discussed science fiction cases of “division” and teletransportation, around the time Star Trek was popular. Imagine that teletransportation becomes possible. Your body can be dematerialised here on earth and rematerialized on some distant planet. But what if the original was mistakenly not destroyed in the process and there was Julian here in Oxford and one Julian on Pluto. Which one would be me? these philosophers asked.

We should address such abstract thought experiments if we are to answer ethical questions around the real life case of conjoined twins. But our answers to these abstract questions can be helped by our practical ethical inquiry. As I have argued, conjoined twins are two persons who share one body. Why is this important?

The excellent film, Sixth Day, examines the ethics of cloning. In it, Arnold Schwarzenegger is cloned without his knowledge. His body is replicated and all his mental states are transferred to the copy. Like the philosophers’ science fiction case of teletransportation, the original is not destroyed. The “copy” of Arnie is unaware of the process. He lives with the wife and children as before. The film finishes after the two Arnies unite and kill the baddy and reconcile – the “copy” chooses to go off to sea and leave the family to the original Arnie.

Yet if our analysis of the conjoined twins is right, the cloning process (cerebral syncoiding) creates identical twins, like the division of the embryo. Neither has a greater right to be the husband, father or to the property. Both Arnies had a right to be with the wife. Perhaps they discussed this, behind the scenes, or perhaps it would not have made for the usual happy, Puritan ending of a Hollywood movie.

Sometimes, theoretical philosophy can be assisted practical ethics. Even if there is no answer to who the “real” person is, we can answer questions about how they should be treated, and treat others. The “copy” is not some kind of inferior forgery. To claim that the clone somehow has few rights or status is an example of “clonism”, or discrimination against clones. This happens in movies and in real life, when one clone is described as a parasite.

We should speak up for the rights and dignity of clones. Teletransportation may not occur in the medium term future. But sometime this century, it may be possible to upload human mental states or information to artificial intelligence. The rights and interests of such artificial clones will raise similar ethical dilemmas.

What is science fiction is in some ways with us now. And how decide the present cases of the fate of conjoined twins may decide how we react to future, now science-fiction cases.

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2 Responses to Conjoined Twins, Cloning and Artificial Intelligence

  • Brad Arnold says:

    A fundamental pillar in Western philosophy is the argument: I think, therefore I am. This unfortunately is a truism. Posit an “I,” then declare “I.” The ego is embedded in our language, logic, and therefore our ethics. This particular premise will soon be challenged in a big way, as man merges with machine in a decade or two. Where does man end and machine begin? When AI becomes more intelligent than a human around mid-century, is the “mind” of a machine any less valid than a “mind” of man? Where does your fist go when you open your hand? The answer is obvious, it is just our language that hides the truth. I look into your eyes and see myself.

  • [T]he cloning process (cerebral syncoiding) creates identical twins, like the division of the embryo. Neither has a greater right to be the husband, father or to the property.

    This inference seems a bit hasty. Identical twins don’t have a right to their twin’s property (let alone spouse and children!). They have rights, like any other person, to acquire their own property, and develop their own relationships. To get your conclusion, you need more than the premise that a clone is morally equivalent to an identical twin, with the same general rights that any person has; you need the much stronger claim that they have as much claim to the very identity of the original person.

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