The irreversibly comatose: respect for the subhuman in human life.

In the case of the irreversibly comatose patient, though no personal consciousness remains, some moral duty is owed the remaining biological life. Such an ending to human life, if pathetic, is also both intelligible and meaningful in a biological and evolutionary perspective. By distinguishing between the human subjective life and the spontaneous objective life, we can recognize a naturalistic principle in medical ethics, contrary to a current tendency to defend purely humanistic norms. This principle has applications in clinical care in the definition of death, in the use of life support therapy, in distinguishing ordinary from extraordinary therapy, in evaluating euthanasia, and in the extent of appropriate medical intervention in terminal cases.