Failed surgery fuels ethics debate

Two Iranian women pray as they listen to a Muslim preacher reciting the Koran in Singapore, July 9. Iranians gathered for a private farewell to Ladan and Laleh Bijani, the twin sisters who died whithin minutes of achieving their 29-year-old separation. Photo: AFP

The 29-year-old sisters, Ladan and Laleh Bijani, had made it clear they were willing to risk death in high-risk surgery for a chance to pursue separate dreams and live out their lives in different cities.

"They gambled and have lost," was the verdict of Singapore's Straits Times newspaper, which nevertheless noted the unprecedented procedure was "history in the making."

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Iranians in the city state were in a somber mood as they gathered to hold prayers for the two women at a private home.

"I think the doctors have an obligation to fulfill the wishes of their patients," said Ali Homayouni, 25, an Iranian law student who had visited the twins in the hospital.

"It was their duty to make sure they do the best job they could given the circumstances," he said.

But medical experts were more critical, concerned about the haste and motives behind the surgery.

"There are troubling aspects about this case," Dr Ian Kerridge, Associate Professor in bioethics at Sydney University's Center for Values, Ethics and the Law in Medicine told Reuters.

"...and one of them was the statement by one of the surgeons that they found it was more difficult than they had expected. To me that sets off a little bit of an alarm bell."

Kerridge suggested doctors could have let the girls wait for a year, talk to people who have not had the surgery or to people who felt it was wrong.

The man who had adopted and brought up the sisters in Iran, Alireza Safaian, a doctor himself, wept as he spoke to Reuters at his home in southwestern Tehran of the decision by his daughters and the Singapore doctors to go ahead with an operation.

"When they took them to Singapore, I knew they would bring back their bodies. They took them there and killed them."

Twins joined at the head occur once in every two million live births. A separation operation had never been tried on adults.

Dr Keith Goh, who led the team of 28 specialists and 100 assistants in the 52-hour long operation, defended the decision.

"I think that for those of us who were here over these last three days, for those of us who flew in from all over the world...the time and commitment is a convincing indication of their belief that the decision is correct," Goh told a news conference.