Sunday, July 27, 2003

Taken from the July 21 issue of Time (Asia) magazine, titled "A Doctor's Duty", and written by Charles Krauthammer, dwelling on the case of the Iranian twins:

"When you lose a patient, particularly when the patient dies at your own hand, the heartbreak mixes with unbearable guilt. The doctors are asking themselves the same question everyone else is asking: Should they have done it?

The doctors certainly knew the risk. They knew that with the women's shared circulatory systems, the risk was great. They might have underestimated the technical challenges, but they did not deceive their patients. The sisters, highly educated and highly motivated, knew full well the risk of never waking up from the surgery.

For all the regrets and second guesses, it is hard to see how the answer could have been anything but yes. The foundation of the medical vocation is that the doctor is servant to the patient's will. Not always, of course. There are times when the doctor must say no. Thie was not such a time.

Before serving a patient's will, doctors have to decide whether it is perverse and self-destructive.

Beyond that, the patient is sovereign and the physician's duty is to be the servant. Which is why the doctors in Singapore were right to try to separate the twins. They were not seeking self-destruction: they were seeking liberation. And they were trying to undo a form of mutilation imposed on them by nature. The extraordinary thing about their request was that it was so utterly ordinary. They were asking for nothing special, nothing superhuman, nothing radically enhancing of the human nature. They were only seeking to satisfy the most simple and pedestrian of desires: to live as single human beings.

To risk everything for this was perfectly rational -- indeed, an act of nobility and great courgae. Their doctors were assisting heroism, not suicide. They should feel no guilt, only sorrow that victory once again went to nature, in all its cruelty."

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