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This article examines the relationship between the principle of double effect and justification for separation surgeries for conjoined twins. First, the principle of double effect is examined in light of its historical context. It is argued that it can only operate under an absolutist view of good and evil that is compatible with the Bible. Given this foundation for application, scenarios for separating conjoined twins are considered against the criteria for the principle of double effect. Itdoi:10.1080/13803600601054512 pmid:17162676 fatcat:uq3wnkdjtravjdru4lx6mj6z2q