Resculpting the Unconcsious Violinist Redux

Judith Jarvis Thompson's famous "Unconscious Violinist" argument in favor of abortion is posited thus:

You wake up in the morning and find yourself back to back in bed with an unconscious violinist. A famous unconscious violinist. He has been found to have a fatal kidney ailment, and the Society of Music Lovers has canvassed all the available medical records and found that you alone have the right blood type to help. They have therefore kidnapped you, and last night the violinist's circulatory system was plugged into yours, so that your kidneys can be used to extract poisons from his blood as well as your own. The director of the hospital now tells you, "Look, we're sorry the Society of Music Lovers did this to you—we would never have permitted it if we had known. But still, they did it, and the violinist now is plugged into you. To unplug you would be to kill him. But never mind, it's only for nine months. By then he will have recovered from his ailment, and can safely be unplugged from you.

Greater minds than mine have plucked this argument apart. Unstringing the Violinist is an excellent example. I did a bit more in Resculpting the Unconscious Violinist, similar to what I did with the forced kidney donation argument: tweaking it until it becomes more analogous to pregnancy by addressing several key points in which the Unconscious Violinist differs from pregnancy and abortion:

• The unborn child is not a stranger. 
• Except in rare cases of rape pregnancy, the pregnant woman has engaged willingly in an act that she knew might leave her "hooked up" to her child.
• Pregnancy does not, except in rare cases, leave a woman confined to bed. She is quite free to go about her business, albeit somewhat awkwardly in the later months.
• Abortion is not merely "unplugging" the unborn child. It is taking active, usually violent, steps to kill him. He is poisoned or dismembered or stabbed.

But there is one more key difference that had until recently utterly eluded me: The violinist is already dying.The unborn child is not.

Due to his kidney disease, the violinist has reached the end of his natural life. Without technological intervention, he will, in the course of nature, die soon.The unborn child is at the beginning of her natural life. Without technological intervention, she will live for decades, perhaps even for a century.

With the violinist, technological intervention is an act of mercy and kindness which extends his natural life. Withdrawing the intervention, while it might be unmerciful and unkind, is not causing the violinist's dying state.

With the unborn child, technological intervention is an act of violence which ends her natural life. It is the intervention itself that would cause the unborn child to enter into a dying state that is contrary to the natural trajectory of her life.

We have to imagine a scenario in which a person is dependent, but not because he is dying and needs extraordinary measures. The person's state of dependence has to be one that arose naturally, one in which it is intervention that causes the death.

Let's imagine conjoined twins, Sally and Jane. They were never separated because their internal organs are so intertwined that there is no way both of them could survive the surgery. Both are in excellent health otherwise. Sally is smaller and thus dependent upon Jane in many ways.

One day Jane declares that enough is enough. Her life with Sally is simply too constricted and limited. She wants separation surgery even though it will result in Sally's death. Assuming that there are doctors willing to perform surgery that will cause Sally's death, should they be allowed to proceed?

As they were assessing the twins, one of the doctors discovered that there is a way to separate the twins without causing Sally's death. He can perform a preliminary surgery on Sally, implanting a small lattice soaked in her stem cells. Her body will then build upon this lattice and naturally become less dependent upon her original organs that were so entangled with Jane's. If Jane just waits a few months and endures some additional discomfort as Sally's new organs grow, she can be successfully separated from her sister without causing Sally's death. Should Jane be required to wait, or should she be allowed to insist that the separation surgery be performed immediately?