Doctors defend op decision

2003-07-08 16:54

Singapore - Doctors involved in the surgery that led to the deaths of conjoined Iranian twins Ladan and Laleh Bijani on Tuesday admitted the operation would raise ethical questions, but they maintained their decision to proceed was correct.

"I think that the debate, the argument and the controversies will go on forever and ever," Singaporean neurosurgeon Keith Goh, who led the team of 24 doctors and about 100 medical staff, told a packed news conference at Raffles Hospital after the sisters died.

"But I think that for those of us who were here over the last three days, the time and the commitment ... is a convincing indication of the belief that the decision was correct."

Having seen and understood how the twins, fused at the head since they were born 29 years ago, had longed to be separated, Goh said other world experts would agree with him and his team that the decision to operate was correct.

50/50

Consulting neurosurgeon Benjamin Carson, from the world-renowned Johns Hopkins Children's Centre in the United States, said doctors had gone into the operation knowing there was a 50% chance the twins would die.

"(But) the fact of the matter is that these were individuals who were absolutely determined to be separated," Carson said.

"And the reason I felt compelled to become involved was because I wanted to make sure that they had the best chance."

Carson, who has successfully separated three sets of conjoined twins, said he was convinced the twins would have continued searching for someone to operate on them until someone finally agreed.

"I thought that this could be their best opportunity, even recongnising that that the odds were not good and I think it was a worthy humanitarian effort," he said.

Surprise

Despite his insistence that the decision was correct, Goh, who led a team that successfully separated Nepalese twins in 2001, admitted the complexities of the Bijanis case had surpised him once the operation was underway.

"What we have begun to understand in this case, which was not revealed in the pre-operation angiograms and vascular studies ... are that the patterns of blood flow through such abnormally joined brains is hard to predict," Goh said.

Loo Choon Yong, the executive director of the Raffles Medical Group that runs the hospital, put it more succinctly.

"It was harder than we anticipated," he said.

- AFX