Deciding on a procedure where one twin may die so the other can live is almost too difficult a judgment to make, but for Friar Cormac Nagle, this is the sort of gut wrenching dilemma he faces on a regular basis as ethicist for Mercy Health Care at the Mercy Hospital for Women in Heidelberg, Melbourne.

While his role is varied and includes his participation on the Research Ethics Committee and as Patient Advocate for Gynaecological Oncology, one of Cormac's main jobs is at the neo-natal intensive care unit.

It is here Cormac deals with the intensely emotional and problematic issues facing families of premature babies. Being one of only three hospitals in Victoria with a third level neo-natal intensive care unit, babies are often flown in from many parts of the state, including rural Victoria.

"Many of the premature babies were conceived via IVF - up to a third of all pre-term babies born,” Cormac said, "and we need to know more about the causes. It is an emotional area. We are dealing with life and death issues. We face issues dealing with tricky deliveries, babies born with defects and other health issues.

While there are many heartbreaking stories of pre-term babies dying, there are also the many who survive. “The chances of a baby surviving under 24 weeks was quite low a few years ago. Now, they have a much better chance of life. The youngest baby to survive was born at 23 weeks.”

  But, getting to the point of making these life and death decision is, to say the least, difficult.

“Recently we had a mother who was carrying twins and one of the twins had no brain and no heart and was living off the healthy twin,” he said. “When we make decisions, it is important to make it on the information we have at the present. It's no use thinking about what could happen in the future or else you would drive yourself mad".

“One must look at the facts first, and the consequences of those, and make a decision that is not just based abstractedly on principle.”

While Cormac agrees that general principles need to be applied to the current situation, a decision must also be made in the best interest of the person.

“Sometimes I'll head down to the chapel and say a prayer. But, I must also listen to the experts who have done the background study.”

At 79 years of age, does Cormac have any prospects of slowing down? “The hospital is a very intense place to work, but it's also very rewarding. I'll be here as long as they'll have me.”

Cormac continues teaching Moral Theology at the Yarra Theological Union, Box Hill. This includes supervising theses for post-graduate degrees, a fairly time-consuming task. He tries to publish one article a year, the latest one being on “Genetic Testing and Insurance”.