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[Ethical problems in dialysis in elderly patients].

S Alloatti1, D Gabrielli, A Molino

  • 1U.O. di Nefrologia e Dialisi dell Ospedale di Aosta, Aosta, Italy. nephroaosta@libero.it

Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia
|March 21, 2003
PubMed
Summary

Deciding on dialysis for elderly patients is complex due to varying criteria. Clinical assessment, patient autonomy, and ethical principles guide treatment decisions, not economics.

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Area of Science:

  • Nephrology
  • Geriatrics
  • Medical Ethics

Context:

  • Increasing incidence and prevalence of elderly patients in dialysis facilities.
  • Difficulties in clinical assessment and wide variations in selection criteria for elderly dialysis patients.
  • Need for suitable care units and standardized decision-making processes.

Purpose:

  • To discuss complex arguments for and against dialysis in elderly patients.
  • To explore the application of Kantian deontology (beneficence, non-maleficence, autonomy) in decision-making.
  • To highlight the importance of patient-centered care, family involvement, and team discussion.

Summary:

  • Clinical assessment of elderly patients for dialysis is challenging, with criteria varying globally and locally.

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  • Ethical principles, patient autonomy, family involvement, and team consensus are crucial for treatment decisions.
  • Treatment may be initiated, continued, or discontinued based on comprehensive medical evaluation, not economic factors.

    • Impact:

    • Facilitates ethical decision-making in complex cases of elderly patients undergoing dialysis.
    • Promotes patient-centered care and shared decision-making in geriatric nephrology.
    • Advocates for medical-clinical assessment as the sole determinant for dialysis treatment in the elderly.