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The Case of Maltese Couple, Michaelangelo and Rina Attard vs. the British High Court,
Regarding Re A (conjoined twins)

Submitted by:

Name

Date:
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Introduction
On August 8, 2000, conjoined twins Jodie and Mary were born at St Mary's Hospital in
Manchester, United Kingdom. The twin sisters were born with a joined abdomen, fused spine,
and one functioning heart and a set lungs that resided in Jodie. Mary’s lungs, the brain and heart
were so poorly developed and she had to depend on Jodie for blood circulation and oxygen,
meaning that she could not exist without her twin sister (BBC News, 2000). According to the
doctors, the babies were likely to die if they were to remain conjoined before reaching six
months. They believed that Jodie could survive the surgery operation because her lungs and heart
were functional and she had no life threatening problems. However, the separation would lead to
Mary’s death. This case was taken to the British High Court which ruled in favor of the doctors
who wished to separate the girls, and then appealed by the couple to the court of appeal, where
judges made an agonizing decision to give a go-ahead to separate the twins (Parisa & Elias-
Jonesb, 2001). The surgery to separate the conjoined twins took place on the 7 th of November,
2000.
The following background section discusses legal reverberations of the twins’ predicament by
the British court to issue a ruling on the legality of surgery procedure to separate Jodie and Mary,
against the wishes of the couple and how the court reached on this decision.
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Background
When the couple refused consent to have the twins separated, the St. Mary’s hospital submitted
summons entitled “In the exercise of the inherent jurisdiction of the High Court and in the
matter of the Children’s Act 1989” (Sawday, 2000) on 18th of August 2000. The originating
summons asked the court to lawfully issue a declaratory relief to allow the doctors carry out the
surgery to separate the conjoined twins without approval from their parents. The parents, who
were of Catholic faith, strongly believed that the fate of the twins was with God and they wanted
nothing but to provide medical care and allow the nature’s course through the will of God. The
hospital was granted this petition on 25th of August 2000 in London by Justice Johnson, a judge
of the family division of the British High Court.

Justice Johnson’s decision was focused on Mary’s condition, questioning her ability to live
independently without Jodie. He also considered the legalities of the surgery operation to
separate the twins and found that the act was lawful under the British law. However, the couple’s
lawyers and the Official Solicitor representing Mary’s interests applied for leave to appeal
against the decision by Justice Johnson to the British Court of Appeals. They appealed that the
twins would not be on any medical treatment, including surgery to separate them without the
consent of their parents. They stated in their appeal that Justice Johnson’s decision was wrong
considering that: (a) separation surgery would not be in Mary’s best interests; (b) separation
surgery would not be in Jordy’s best interests; and (c) even if separation surgery would in the
best interests either one or both girls, it would be unlawful (Ward, et al., 2001).

On 25th of September 2000, Justices Brook, Ward and Walker upheld Justice Johnson’s ruling.
The decision by the Justice Johnson was appealed on the basis that he (Justice Johnson) erred in
holding: (a) the operation was in Jodie’s best interest; (b) the operation was in Mary’s best
interest; (c) the operation to separate the conjoined twins was lawful (Sawday, 2000). The three
justices (Justices Brook, Ward and Walker) at The Court of Appeals finally upheld the decision
made by Justice Johnson on the aspects of family, medical and criminal law. The couple decided
that they were not going to seek a review of the ruling of the Court of Appeal to the House of
Lords, and based on this decision, the Official Solicitor also made up a choice not to appeal.

The couple felt that they had done their best for their girls and decided that they will push the
case no further. After gaining the legal permission to separate the girls, the doctors later
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considered abandoning the procedure since the couple vehemently opposed the surgery.
Nevertheless, the girls were separated on 7th of November 2000 in an operation that took 20
hours at St. Mary’s hospital. As predicted, Mary died shortly after the operation, while Jodie was
in a critical but stable condition. Jodie managed to survive and continued to improve days after
the operation (Smith, 2000). She was released from the hospital in June 2001 and taken home by
her parents.
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References
BBC News, 2000. Jodie and Mary: The medical facts. [Online]
Available at: http://news.bbc.co.uk/2/hi/health/920487.stm
[Accessed 9 December 2016].

Parisa, J. J. & Elias-Jonesb, A. C., 2001. “Do we murder Mary to save Jodie?” An ethical
analysis of the separation of the Manchester conjoined twins. Postgraduate Medical Journal,
77(911), pp. 593-598.

Sawday, J. N., 2000. Separating Conjoined Twins: Legal Reverberations of Jodie and Mary's
Predicament. Loyola of Los Angeles International and Comparative Law Review, 24(1), pp. 65-
86.

Smith, A. M., 2000. The separating of conjoined twins. BMJ, Volume 321, p. 782.

Ward, Brooke & Walker, R., 2001. In Re A (Children) (Conjoined Twins: Surgical Separation)
[2001] Fam 147. [Online]
Available at: https://www.google.com/url?
sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwjHnOvbj-
fQAhWC2RoKHcoKA9kQFggZMAA&url=http%3A%2F%2Fwww.mentalhealthlaw.co.uk
%2Fmedia%2FRe_A_(Conjoined_Twins)_(2001)_Fam_147_report.pdf&usg=AFQjCNGl3Y-
rglfCTq9UmbD5r
[Accessed 9 December 2016].