The complicated medical and ethical issues involved in the care of comatose patients have led to significant indecision, dialogue, and debate regarding forensic aspects of care. While the forensic nursing specialty remains in its formative years, sound, ethical decisionmaking requires the respectful and open exchange of views between and among all individuals with relevant interests. Forensic nurses must recognize, demonstrate, and defend any practice regarding comatose patients within the ethical nursing provision that mandates a nurse’s primary commitment is to the patient, requiring nurses to promote, advocate for, and strive to protect the health, safety, and rights of all patients. Since 1996, the American Nurses Association has recognized forensic nursing as a formal specialty. Despite this recognition, Sexual Assault Nurse Examiners and Emergency Department nurses struggle with incorporating evidence collection into the care they give the unconscious or comatose patient they suspect has been sexually assaulted. This article addresses the need to collect evidence and treat the unconscious patient in a way that improves both patient health and legal outcome. Tables and references