{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:39:11Z","timestamp":1791477551203,"version":"4.3.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,8,21]],"date-time":"2018-08-21T00:00:00Z","timestamp":1534809600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>A recent case of conjoined twins required multiple hospitalizations in the pediatric intensive care unit and led to a difficult situation confronting staff regarding the potential separation where surgery would result in the death of one twin. The hospital ethics committee was consulted. A systematic approach was utilized to examine medical standards, historical precedents, and various ethical and legal frameworks. The ethics committee believed that either proceeding with or forgoing attempted separation surgery would be ethically acceptable. We share our reasoning and lessons learned for others facing this situation in the future.<\/jats:p>","DOI":"10.1177\/0885066618791953","type":"journal-article","created":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T00:09:48Z","timestamp":1534896588000},"page":"81-84","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Conjoined Twins Separation Leading to the Death of One Twin: An Expanded Ethical Analysis of Issues Facing the ICU Team"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7701-9354","authenticated-orcid":false,"given":"Brian M.","family":"Cummings","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care, MGH Pediatrics Ethics Committee, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Paris","sequence":"additional","affiliation":[{"name":"Department of Theology, Boston College, Chestnut Hill, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,8,21]]},"reference":[{"key":"bibr1-0885066618791953","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcpc1706105"},{"key":"bibr2-0885066618791953","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.10.1307"},{"key":"bibr3-0885066618791953","doi-asserted-by":"publisher","DOI":"10.2307\/3527600"},{"issue":"6","key":"bibr4-0885066618791953","first-page":"549","volume":"170","author":"Hoyle RM","year":"1990","journal-title":"Surg Gynecol Obstet"},{"key":"bibr5-0885066618791953","doi-asserted-by":"publisher","DOI":"10.2307\/3562040"},{"key":"bibr6-0885066618791953","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.77.911.593"},{"key":"bibr7-0885066618791953","doi-asserted-by":"crossref","unstructured":"re Quinlan 70 N.J. 10, 335 A.2d 647. 1976.","DOI":"10.1093\/jee\/70.3.335"},{"key":"bibr8-0885066618791953","unstructured":"Superintendent of Belchertown State School v. Saikewicz, 373 Mass 728, 370 N.E. 2d 417. 1977."},{"key":"bibr9-0885066618791953","doi-asserted-by":"crossref","unstructured":"Custody of a Minor (No.1). 385 Mass.697. 1982.","DOI":"10.1016\/0167-4781(82)90104-X"},{"key":"bibr10-0885066618791953","unstructured":"New York Times\n                      , January 10, 1994: 1."},{"key":"bibr11-0885066618791953","unstructured":"Cormac Murphy-O\u2019Connor, \u201cSiamese Twins, Jodie & Mary,\u201d a submission by Archbishop Cormac Murphy-O\u2019Connor, Archbishop of Westminster, to the Court of Appeal in the case of\n                      Central Manchester Healthcare Trust v. Mr. and Mrs. A and Re A Child (by Her Guardian Ad Litem, The Official Solicitor)\n                      , 14 September 2000.\n                      Origins\n                      30 (October 5, 2000) 269\u201372. http:\/\/www.cmq.org.uk\/CMQ\/2000\/conjoined_twinsI.htm. Accessed July 6, 2018."},{"key":"bibr12-0885066618791953","unstructured":"Central Manchester Healthcare Trust vs. Mr. and Mrs. A and re A, a Child, [200] 2 WLR 480."},{"key":"bibr13-0885066618791953","unstructured":"O\u2019Rourke K. Separating the Lakeburg twins: ethical issues. Health Care Ethics. 1994;2:1\u20133."},{"key":"bibr14-0885066618791953","doi-asserted-by":"publisher","DOI":"10.1177\/004056390106200404"},{"key":"bibr15-0885066618791953","volume-title":"Just and Unjust Wars: A Moral Argument With Historical Illustrations","author":"Waltzer M.","year":"2015","edition":"5"},{"issue":"3","key":"bibr16-0885066618791953","first-page":"215","volume":"47","author":"McCartney JJ","year":"1980","journal-title":"Linacre Q"}],"container-title":["Journal of Intensive Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0885066618791953","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0885066618791953","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0885066618791953","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:56:22Z","timestamp":1777503382000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0885066618791953"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,21]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1177\/0885066618791953"],"URL":"https:\/\/doi.org\/10.1177\/0885066618791953","relation":{},"ISSN":["0885-0666","1525-1489"],"issn-type":[{"value":"0885-0666","type":"print"},{"value":"1525-1489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,21]]}}}