An elderly man with end-stage emphysema presents to the emergency room awake and alert and complaining of shortness of breath. An evaluation reveals that he has pneumonia. His condition deteriorates in the emergency room and he has impending respiratory failure, though he remains awake and alert. The hospital has on file for him a copy of a signed and witnessed living will which stipulates that he wants no "invasive" medical procedures that would "serve only to prolong my death." No surrogate decision maker is available. Should mechanical ventilation be instituted

The use of the mechanical ventilation should be based on the elderly man's decision after you must have explained the pros and cons of using the mechanical ventilation as reports have shown that in as much that mechanical ventilation can "prolong death", it can also help to revive back his respiratory abilities. if his decision is to use the mechanical ventilation after understanding your explanation, only then can mechanical ventilation be used.