Mechanical ventilation is a method used to assist or replace spontaneous breathing for a patient whose breathing patterns have stopped working properly. Doctors will also use mechanical ventilation to control breathing or when they believe other physiological functions are about to shut down.

The ventilator doesn’t cause pain, but some patients dislike the feeling of having a tube in their mouth or nose. As well, patients cannot talk or eat while the tube is in place, so it can be inconvenient or even frightening.

Understandably, the sight of a loved one being assisted by a ventilator can be disturbing. Although it keeps the patient alive, it can also remind families of the proximity of death. Over time, however, as loved ones spend more time with the patient, the sight of the ventilator becomes less alarming.

The decision to use mechanical ventilation is rarely a simple one, especially given the possible risks associated with using a ventilator—infection, lung collapse, lung damage and, most importantly, quality of life. Mechanical ventilation can give reprieve for a sick loved one, but if they have no hope for survival, it may cause more trauma than relief.

How long should a patient be left on mechanical ventilation? Your doctor can provide advice, but ultimately the answer to this question depends on the wishes and personal beliefs of the patient or the family.

Make sure that you write down your wishes – and if you are responsible for caring for another individual, make sure you understand their wishes. It may make all the difference to the quality of your and their end of life care.

Dr. Daren Heyland is a Professor of Medicine and Epidemiology at Queen’s University, Kingston, Ontario Canada and the Director of Canadian Researchers at the End of Life Network (CARENET), a group of health care professionals from across the country who collaborate with each other to understand and improve palliative and end-of-life care. For more information, please visit www.thecarenet.ca