London The Court of Appeal ruled Friday that surgeons may separate 1 1/2-month-old Siamese twins against the wishes of their Roman Catholic parents, but the agonizing moral and medical issues could go to the House of Lords, Britain's highest court, if the parents wish.
The judges concluded the case came down to an issue of self-defense the right of the stronger twin to be released from a sister who would eventually kill them both.
In their unanimous decision, the three-judge panel expressed sympathy with the cruel reality faced by parents whose daughters are "equal in their eyes and in their love."
"The sad fact is that (the weaker twin) lives on borrowed time, all of it borrowed from her sister," said Lord Justice Alan Ward. "She is incapable of independent existence. She is designated for death."
Doctors said the girls, identified only as Jodie and Mary, will die within months if they are not separated, but that Jodie could live on her own.
The parents, who were determined to submit to "God's will," had appealed a lower court ruling in favor of surgery.
The case may not be over the parents were permitted to appeal Friday's decision to the House of Lords, Britain's highest court, although they were uncertain whether they would do so.
The parents, identified only as Roman Catholics from the Maltese island of Gozo in the Mediterranean, came to Britain for the Aug. 8 birth of the twins, who were joined at the lower abdomen.
The court had struggled with the issue of whether the surgery would amount to intentionally killing Mary, whose heart and lungs cannot sustain life.
"Mary's death would not be the purpose of the operation, although it would be its inevitable consequence. The operation would give her, even in death, bodily integrity as a human being. She would die, not because she was intentionally killed, but because her own body cannot sustain her life," Justice Robert Walker said.