Disconnecting the ventilator: life saving or death delaying?

Mechanical ventilators have supported patients with respiratory failure from the era of the polio epidemics to the present. While ventilators can clearly be life saving, many patients receiving this intervention do not survive. In such patients, this treatment is not life saving, but death delaying. Other patients treated with mechanical ventilation may survive, but do not improve to the point where they can become independent of the ventilator. This paper is a review of the prognosis and cost of respiratory failure, ethical issues in removing patients from the ventilator and methods of discontinuing respiratory support.