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Coma is best understood as an eyes-closed unconsciousness. The patient appears asleep, but unlike normal sleep, the patient cannot be awakened and the eyes remain closed. The body may be motionless or there may be various reflex body movements, but there is no purposeful body movement. The patient cannot communicate and has no awareness of self or the environment around them but the person is living.
Coma is not the same as Brain Death. Coma is also not the same as another condition with which it is sometimes confused known as the Persistent Vegetative State.
The vegetative state is best understood as an eyes- open unconsciousness. It was first described in medical literature in 1972. As with comatose patients, the vegetative patient has no awareness of self or the environment. Unlike coma patients, the vegetative patient has open eyes at times and has sleep-wake cycles. Although the vegetative patient has sleep-wake cycles, the patient is not conscious of their surroundings when their eyes are open. There is no comprehension or expression of language. Reflex movements may occur but there is no sustained, purposeful and voluntary response to unpleasant stimuli. The eyes may roam about the room aimlessly. The patient may appear to be looking at you or to briefly track an object, but cannot track the object consistently. The patient may have variable facial expressions such as grimaces or smiles but the patient does not follow commands.3 Because the patient’s eyes are open and some body movements exist, families may often be given false hope that their loved one is returning to normal when they are not.
Unlike persistent vegetative state, brain death is defined as the permanent loss of function of all parts of the brain. The standard criteria were first published in medical literature in 1968. When a patient is declared brain dead, they are legally dead. In brain death, the entire brain has died, both the upper parts of the brain (cerebrum) and the lower parts of the brain (brain stem). The cerebrum or upper brain is responsible for voluntary movement, thinking, hearing, seeing, feeling emotions and more. It is responsible for what you are doing as you read this information. The brain stem or lower brain is responsible for the vegetative functions such as breathing or sleeping and waking up (sleep-wake cycles). If you use your upper brain and think about it for a moment, you will quickly realize you don’t have to tell yourself to breathe. Breathing is a basic vegetative function that happens automatically.
In order to answer this question, one must be aware of the defining feature of life which is CONSCIOUSNESS .
Consciousness is the property of an organism to be able to sense environmental stimuli and generate a subsequent response through interaction of the body with the surroundings i.e. a living being is aware of the chemicals in its body which are in a transit state in order to perform metabolic reactions to maintain homeostasis .
Life is a non-equilibrium steady state which requires a continuous input of energy so as to avoid equilibrium state.
Now, coming to the point, a coma patient is also in a non-equilibrium steady state (general bodily functions i.e. metabolic reactions occur continuously) and most importantly, the coma patient is also conscious (not physically and you know that) but at the biological level.
He/she is definitely living and it is very similar to the state of long sleep.
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