Well we have learned that even when you have advance directives in place and a medical surrogate to convey your wishes about invasive procedures, sometimes they happen anyhow. Mama has done all of that and yet, there we were in the ER having to make an immediate decision about putting her on a ventilator. She was rapidly losing her ability to breathe in the midst of a congestive heart failure episode and the nurse was pressing us for a decision. She promised us that it would be A)temporary and B) that she would be sedated the entire time. She lied about B). Well, she didn't lie, she was a wonderful, caring nurse but some hours after the vent had been started Mama's blood pressure tanked and they had to back off of the sedation to counteract that. They did give her morphine and ativan to help try to keep her comfortable but I ended up feeling betrayed and guilt-ridden nonetheless. She was on the vent for 4 days and a feeding tube for 2 (another thing we had discussed and Mama didn't want - more guilt). She's still in ICU with a lot of medical "issues" but we will deal with them. I thank God for wonderful, amazing Dr. G (not the medical examiner one) who runs interference for Mama as her primary care doc and keeps the specialists at bay who are programmed to want to "fix" things even when sometimes it's best that they're simply managed instead. Like I said, it's complicated.