What is the vegetative state?
Complete absence of behavioral evidence
for self or environmental awareness
- There is preserved capacity for
spontaneous or stimulus–induced arousal, evidenced by sleep–wake cycles
i.e. patients are awake, but have no awareness. This means that the
patients appear awake. They have normal heart beat and breathing, and do
not require advanced life support to preserve life and cannot produce a
purposeful, co–coordinated, voluntary response in a sustained manner,
although they may have primitive reflexive responses to light, sound,
touch or pain.
- Patients cannot understand,
communicate, speak, or have emotions and unaware of self and environment
and have no interaction with voluntarily control passing of urine or
stools. They sleep and awaken. As the centers in the brain controlling the
heart and breathing are intact, there is no threat to life, and patients
can survive for many years with expert nursing care.
- The following behaviors may be
seen in the vegetative state:
- Sleep–wake cycles with eyes
closed, then opened. Patient breathes on her own; Spontaneous blinking
and roving eye movements; Produce sounds but no words; Visual pursuit
following an object with her eyes; Grimacing to pain; changing facial
expression; Yawning; chewing jaw movements; swallowing of own spit; no
purposeful limb movements; arching of back; reflex withdrawal from
painful stimuli; brief movements of head or eyes toward sound or movement
without apparent localization or fixation; startled reaction on a loud
sound.
Almost all of these features consistent
with the diagnosis of permanent vegetative state were present during the
medical examination of Aruna Shaunbag; behavior suggestive of a minimally
conscious not vegetative state observed during the examination.
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