[The decision making process of ESRD families during the dialysis withdrawal period]

Hemodialysis is a financial burden to the state and families and the cause of much suffering in patients. It is a life prolonging therapy and death-delaying treatment. When the burdens of therapy substantially outweigh its benefits, withdrawal from dialysis is an appropriate option. However, considering the ethical and legal concerns of doing such is something families must face. There has been little research and little understanding of the process of decision-making within families in Taiwan. The process is full of conflicts, worries, guilt, shame, and lack of consensus. Effective communication with the medical team to resolve the conflict and describe the prognosis is necessary in order to reach a consensus and move toward palliative care. The article uses a case report and discusses the process. Finally, the author suggests an approach to making the situation better in the future.