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A persistent vegetative state (PVS) is a condition of patients with severe brain damage in whom coma has progressed to a state of wakefulness without detectable awareness. Recent functional neuroimaging results have shown that some parts of the cerebral cortex are still functioning in 'vegetative' patients. Such studies are disentangling the neural correlates of the vegetative state from the minimally conscious state, and have major clinical consequences in addition to empirical importance for the understanding of consciousness (Laureys, 2000). The minimally conscious state (MCS) is a recently defined clinical condition that differs from the persistent vegetative state (PVS) by the presence of inconsistent, but clearly discernible, behavioral evidence of consciousness (Boly, 2004). Researchers have analyzed functional neuroimaging results and demonstrated that cerebral activity observed in patients in an MCS is more likely to lead to higher-order integrative processes, thought to be necessary for the gain of conscious auditory perception. (Sara et al, 2007). As opposed to brain death and comatose, PVS is not recognized as death in any legal system. This ethical grey area has led to several court cases involving people in a PVS, those who believe that they should be allowed to die, and those who are equally determined that, if recovery is possible, care should continue. This ethical issue raises questions about autonomy, quality of life, appropriate use of resources, the wishes of family members, professional responsibilities, and many more. The syndrome was first described in 1940 by Ernst Kretschmer who called it apallic Syndrome.[1]
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