Patient self-inflicted lung injury – does it really exist?

In a scientific debate, the party making a new claim carries the burden of proof, not the side defending the preexisting state of knowledge (analogous to a defendant's presumption of innocence until evidence is produced to the contrary). Claims for the existence of P-SILI are based on the shakiest of circumstantial evidence. Six decades of research on how to prudently select settings and remove/wean the ventilator at the earliest time were abrogated during a pandemic on the warrant of an unproven hypothetical entity.