- Vegetative state is the 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.
- They cannot understand, communicate, speak, or have
emotions and are unaware of self and environment and have no interaction
with voluntary passage 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 his/her own; spontaneous blinking and roving eye
movements; produce sounds but no words; visual pursuit following an
object with his/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; startles with 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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