It mostly refers to brain death, i. e. irreversible loss of brain function. You can keep such a person “alive” on ventilation, but the person will not survive once taken off ventilation. Their organs are working and the tissues are alive, some reflexes may even work, but the person will never “wake up.” Nerves cannot regenerate once dead, so once you lose a vital function of your brainstem, like respiration, it’s gone forever.
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