Hi there. Tough decision. Myself I think I'd take the surgery. He may be able to come off the vent. If he can't then he deals with it then. The alternative would be to do nothing. Has the doc given him a timeline as to how long he might live without surgery? From what you are saying he'll be forced to use a Bipap soon and may need it 24/7. A vent may be a better idea in the long run. I wish I could give you a better answer. You can call me if you want to talk.
AL.