Diez mitos sobre el retiro de la ventilación mecánica en enfermos terminales / Ten myths about withdrawal of mechanical ventilation in terminal patients

ABSTRACT

The most difficult of treatment limitation decisions, both for physicians and families, is the withdrawal of mechanical ventilation (MV). Many fears and uncer-tainties appear in this decision. They are described as “ten myths” whose falseness is argued in this article. The myths are 1) Withdrawing MV causes the patient’s death; 2) Withdrawing MV is euthanasia; 3) Withholding and withdrawing MV are morally different; 4) MV can be withdrawn only when the patient has asked for it; 5) Chilean law only authorizes to withdraw VM when brain death has occurred; 6) Withdrawing MV cannot be done if the patient is not an organ donor; 7) Physicians who withdraw MV are in high risk of legal claims; 8) To withdraw MV the physician needs an authorization from the hospital ethics committee, lawyer or institutional authority; 9) There is only one way to withdraw MV; 10) Withdrawing MV produces great suffering to the patient’s family. Making clear that these myths are false facilitates appropriate decisions, therefore preventing “therapeutic obstinacy” and more suffering of terminally ill patients, which favors their peaceful death. For the physician this goal should be as rewarding as preventing the death of a curable patient.