If you were from a foreign nation looking at the United States news, you might think that this was a nation that has declared war on death. Or perhaps, this country has denied death entirely.

In California, teenaged Jahi McMath,who has been medically and legally dead for nearly a month (death certificate was issued December 12), has been moved to an unnamed facility and given surgical procedures to introduce air, water and food more easily. Meanwhile, her body continues to degrade and decay.

In Texas, Marlise Munoz, a woman who may be brain dead or may be in a persistent vegetative state, is being maintained due to the hospital’s interpretation of a state law. This way, Munoz may be used as an incubator to keep her 14-week old fetus growing- despite the wishes of her family that she be disconnected from her ventilator.

In California, a mother is facing criticism for exercising her autonomy beyond reason to define death in her own terms. In Texas, a family’s autonomy to make surrogate health care decisions is being denied. Both McMath and Munoz have become objects and tools of various groups.

In California, McMath is now an object of unrealistic hope and political factions. In Texas, Munoz is being made into an object and tool to gestate a fetus that may never be born and may not be viable after oxygen deprivation. Not only has her family expressed their wishes, but Munoz herself had deliberate conversations with loved ones about not wanting to be maintained with the use of artificial support. Lest we forget, the human incubator is now also being used as a political tool for elected officials in attempts to further careers and standing with certain political, religious and social factions.

Ethicists, politicians, physicians and attorneys have taken strong stands and shared opinions on these two cases. There are questions about family decision making autonomy, surrogate decision making, the limits of law, the protection of the unborn, the respect for personal beliefs, the financing the maintenance of the bodies, a state’s interest in unborn life, the poor state of science education, the lack of public education on death and if these situations are some odd confluence of events or precedent-setting.

Some blame McMath’s mother for refusing to accept the reality of her daughter’s death. Others blame a right-leaning state government. There are some placing blame upon a hospital for refusing to acquiesce to a grieving family’s wishes. Still others blame a family that will not give a fetus every chance at being born.

However, I take a different approach as to whom or what is at fault. I blame the ventilator.

If ventilators did not exist, then McMath’s heart would have stopped a month ago, and her mother would have been forced to face her daughter’s death. Without a ventilator, there would be no way to use Munoz as an incubator.

As technologies are created, there is often debate about how we should put them to use. But history has shown that new technologies are usually adopted and used in ways no one could conceive. I suggest it is time we rethink the vent.

Ventilation machines date to the 1800s as negative pressure devices. In 1928, the Drinker respirator was introduced. More refinements came in 1931. These early machines were widely used for polio patients. In 1949, J. H. Emerson designed a vent to be used in anesthesia and in intensive care, predominantly for polio patients and those undergoing surgery. In 1971, a more powerful, smaller and more effective ventilator was introduced. The vent could be used on a wider variety of patients and for longer periods of time.

Sometimes, the ventilator is used to preserve organs for transplant. Since the 1970s, it has been used to keep alive those individuals who lack consciousness—those in a coma or persistent vegetative state.

Apparently in 2014, ventilators are now used to keep the dead functioning as incubators and as vessels of misguided hope. From its early use as a tool to keep those with functioning brains alive, the vent exists now for the purpose of perfusing air into dead bodies.

My suggestion is that we limit the use of the vent, since its use seems to be the problem in these cases. Vents should only be used on those individuals whom can consent. If a patient has consented to organ donation, then that patient has given advance consent to the use of a ventilator. If a patient has a disease that destroys the ability to breathe, that patient can consent. But if a someone starts to bleed and suffers a heart attack that deprives the brain of oxygen to the point of death, that patient cannot consent.

In every other medical aspect, patient consent is required before a doctor so much as touches him or her (with exceptions for emergencies). Why is the opposite true in the case of the ventilator? “Vent now, ask questions later” has become a medical rule.

For example, if one’s kidneys are failing, we do not wait for that person to become unconscious to reflexively put them onto dialysis- requiring consent to remove the treatment or look for documentation stating that this support should removed. In most cases, a person must consent to dialysis before its initiation. This is, of course, an imperfect comparison- waiting ten or 30 minutes to begin dialysis would most likely not be fatal- and waiting that amount of time to ventilate someone not breathing certainly would be.

In present circumstances, if a patient does not want a vent, then an advance directive is required. Why should we accept that we must consent to not being treated, when in most other areas of medicine- the reverse is true?

We should adopt a notion of presumed refusal of ventilators. If a person wants one, then he or she must provide advance consent. Rather than being a first reaction, the vent should only be used when medically appropriate and requested by a patient (or the patient’s legal surrogate or advance directive).

There is likely to be resistance to such a change, as the ventilator is a long accepted part of medicine and has been popularized in the media. It seems that no medical drama would be complete without a ventilated patient. This notion may not have prevented McMath’s mother from consenting to her child’s dead body being kept warm; but moving in this direction would change our expectations that miracle machines- ones that bring people “back from death”- are the norm. Therefore, they should not be expected.

I blame the frequent, automatic use of ventilators for many of these issues and unrealistic expectations. If we change the law, the standard of care and the media’s treatment of these circumstances, then perhaps the tragedies that these two cases represent can be avoided.