THE question of an insensate person's right to be let die would never have arisen before the advances of medical technology. A person who had permanently lost consciousness would have died from lack of nutrition or from complications. Today medicine can prolong a person's `biological life with no prospects of' recovery.

Last July, the courts consented on, behalf of a woman to the withdrawal of tubal feeding and to the provision of palliative care. The woman had been in a persistent, vegetative state for over 20 years. The woman died in her mothers care at home.

In this newspaper recently O'Carroll denied the ethical there is a difference between law and morality. But in this case the judges integrated what is lawful and what is ethical.

The judges stated the principle of the sanctity of life. They accepted", that even though the woman had no consciousness of life it was not a matter of indifference to her, whether she lived or died. Her life still had intrinsic value. This meant that those who claimed continuation of medical intervention was not in her best interests had to prove their claim.

The judges accepted that people, religious or not, believe in the sacredness of life. The principle requires society to reject as intolerable the idea that disabled people could be killed.

They recognised there are, other, ethical principles which we invoke in our decisions about how we should live. There is the principle of respect for personal self determination, the right of the individual to choose how he or she should live his or her own life.

The judges concurred in the view that competent people can decide, for themselves to accept or refused even life sustaining medical treatment.

A related principle is that of respect for dignity. This principle `holds it is wrong to treat a person without respect for the values which give integrity of shape and character to his or her life. We value dignity in life we think it is wrong, when a person fails to show self respect by betraying his or her own values, or when a person is servile in the face of another who denies this or her intrinsic worth as a source of values.

These principles sometimes can be realised in different ways. A Jehovah's Witness who refuses a life sustaining blood transfusion would probably say that he or she is asserting the sanctity of life and the right of self determination. Some people might claim the Jehovah's Witness is offending the principle of the sanctity of life. But to insist that he or she accept life sustaining intervention would be to offend his or her dignity.

The woman had not made a decision about medical intervention. All she had consented to was a gynaecological investigation.

She had not made a decision about life prolonging intervention The judges had to make it for her and they did so in a profoundly ethical way.

The judges underlined that the woman still had a right to respect as, a human equal. Even though she could not make her own decision she still had a right to a decision in her own best interests. This was a crucial move. The judges affirmed that the woman was a part of the ethical community.

If she had been momentarily restored to consciousness with full insight into her predicament, and if she had then directed those caring for her to cease intervention, the carers would have been bound to respect her choice.

Also, her wishes would have been understandable it would have been reasonable for her to say she would prefer to die when her condition was hopeless and treatment wash pointless.

A choice had to be made. To prolong her life by tubal feeding was as much a choice as to end feeding. To operate on her to straighten her legs, to give her antibiotics, to put a catheter in her, to empty her bowels, to put caps on her teeth, to turn her every two hours involved a decision affecting her bodily integrity and her privacy. For the court to leave her in that condition would have been to make a choice.

But the woman was in a persistent vegetative state. Medical intervention gave her no hope whatsoever of regaining consciousness. She was alive but had no conscious life at all. The judges said she still had interests and they had to decide which decision served her best interests. She had no feelings of pain or pleasure but her interests went beyond this. She had interests in privacy, bodily integrity, dignity and in how she lived or died.

The judges considered the woman had a definite interest in the manner of her life and death. They could say from what they learned of, the woman from those closest to her that in her state she would have chosen to die than to live. She was a self reliant person who detested hospitals and medical care. Also refusing treatment in the circumstances harmonised with her religious convictions.

She was being fed by tubes which had been implanted by invasive surgery. She was subjected to intrusive care. She had no prospect of recovery from her hopeless condition. Her dying had simply been prolonged for 22 years. Treatment did not serve her best interests. Therefore, letting her die showed more respect to her as a person than keeping her alive.

HE Medical Council may not ignore the principles of this decision. The council no power to discipline any doctor who acts in accordance with the principles. The council's poverty of ethical imagination in response to the case is disturbing.

Noreen O'Carroll says it cannot be right to deny a permanently insensate person food because starving someone is wrong. Of course it cannot be right to starve another human being because it is cruel and causes death. But she uses emotive words (taken from a dissenting judgment in another case) to create a distressing image of cruelty, suffering and unwelcome death which had no truth in this case.

The woman in the case could not suffer and her condition was such that it was ethically right to let her die. She had an interest in not having a humiliating or distressing death. Suitable sedation and ending feeding comprised the most gentle way in which to let her die. She found her peace in her mother's care.

The brave mother in this case gave back to her daughter something of immeasurable value she let her daughter have a death with dignity that kept faith with the sanctity of her daughter's life.

It was an extraordinary act of human love.