Published online by Cambridge University Press: 29 April 2021
Let us start with a conclusion that seems not to be in dispute: that in April of 1989 Samuel Linares had little or no interest in living. He had been competently diagnosed as being in a persistent vegetative state, by then eight months long. The cause was clearly prolonged asphyxiation, so that whatever uncertainty exists in cases of unknown etiology was not a factor. It could also be claimed that he had little interest in dying, in that he was probably incapable of suffering from prolonged treatment. But few advocate prolonged intensive care for preservation of mere vegetative functions. Nor is there serious argument that patients or surrogates who request discontinuation of treatment in such circumstances, when it serves no interest of the patient, are acting immorally. Even the vitalist federal Baby Doe regulations concede that life-sustaining treatment may be discontinued when the patient is permanently comatose.