New Delhi, Apr 11: Supreme Court judges spent sleepless nights pondering whether to go against the parent's wishes to order a high-risk surgical separation of conjoined twins Saba and Farah but decided to adopt them as court's wards and asked the Bihar government to look after their medical expenses.
In the absence of conclusive medical evidence either in support or against their surgical separation, cost of which was promised to be borne by the Crown Prince of Abu Dhabi Sheikh Mohammed bin Zayed, the court on Wednesday decided against issuing any directions in this regard.
It was pointed out that the separation could take place by conducting 5-6 operations over nine months, but each stage held a 20% chance that either of the girls might die, which was the prime reason for the parents to decide against such medical intervention.
The bench admitted that it had difficulties in deciding competing interests of the parents, who are the natural guardians of the twins and opposed to the operation, on the one hand and the compulsive constitutional urge to save life guaranteed under Article 21, even if it meant death of one of the two.
A bench of Justices K S Radhakrishnan and Dipak Misra said, "We spent sleepless nights to find out a solution. Seldom society cares or knows the mental and psychological trauma judges undergo in such situations, especially when they are called upon to decide an issue touching human life, either to save or take away."
Saba and Farah share a vital blood vessel in the brain. Farah has two kidneys and Saba none. The bench asked an expert medical team from All India Institute of Medical Sciences (AIIMS) to examine the twins. The team appraised the court of the risks involved even in carrying out medical examination of the conjoined twins and the reluctance of the parents to this.
The mother wrote to the medical team that they did not want their agonized daughters to undergo painful medical tests and all that the family wanted was Rs 8,000 per month to take care of them. The parents and brother of the twins were against them being shifted to AIIMS even for further investigation.
The bench said, "We are sorry to note that nobody is concerned with the pain and agony the conjoined twins are undergoing, not even the parents... what they want is financial help as well as palliative care."
The bench took cue from an identical case in England and said, "We are faced with the same situation in this case, since Saba and Farah's parents are against carrying on any investigation as well as surgical operation but being Saba and Farah are ward of this court, this court has got a responsibility to find out whether it is possible to save both and if not, at least one, for which investigation is necessary."
It added, "We are adopting such standards because each life has an inherent value in itself and the right to life guaranteed under Article 21 of the Constitution is of general nature to apply to both Saba and Farah. But what about the inherent value of life of one, who can survive due to surgical separation.
"Is it not necessary to save inherent value of the ward who may survive, not the other? Intrinsic value of both Saba and Farah is equal, but when medical investigation is carried out, a balance sheet has to be drawn up of the advantages and disadvantages which flow from the performance or the non-performance of a surgical treatment. If the balance shifts heavily in favour of one, that has to be accepted, otherwise both will sink and die."
It asked the Patna civil surgeon to periodically examine Saba and Farah and send quarterly status reports to AIIMS to enable it to make independent suggestions. It asked the Bihar government to meet all medical expenses of the twins and also give Rs 5,000 to the family to take care of Saba and Farah.
The bench wanted a six-monthly report on the state of health of the twins and directed the Nitish Kumar government "to move the Supreme Court for further directions, so that better and more scientific and sophisticated treatment could be extended to Saba and Farah".
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