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Death from dialysis termination.

D J Hirsch1

  • 1Department of Medicine, Dalhousie University, Halifax, Nova Scotia.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 1, 1989
PubMed
Summary
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Viable dialysis patients may choose to stop treatment, often due to chronic heart failure. Patient perception, not just age or comorbidities, influences this decision to end dialysis.

Area of Science:

  • Nephrology
  • Bioethics

Background:

  • Dialysis termination by viable patients is a critical ethical and clinical issue.
  • Previous research (Neu and Kjellstrand, 1986) provided limited data on this phenomenon.

Purpose of the Study:

  • To analyze a series of dialysis terminations in Halifax, Nova Scotia.
  • To enhance understanding of treatment rejection by chronic dialysis patients.

Main Methods:

  • Analysis of 178 chronic dialysis patients at risk between January 1982 and May 1987.
  • Identified 11 patients (6%) who stopped dialysis, representing 16% of all patient deaths.

Main Results:

  • Patients stopped dialysis after a mean of 22 months; mean age at death was 67 years.
  • Chronic heart failure was the primary reason for termination, not dementia.
Keywords:
Death and EuthanasiaEmpirical ApproachHalifax (NS)Professional Patient RelationshipVictoria General Hospital (Halifax, Nova Scotia)

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  • Patient perception of their condition, rather than age or comorbidities, appeared critical.
  • Conclusions:

    • Subjective patient perception is a key factor in the decision to stop dialysis.
    • This study adds to the understanding of patient-initiated dialysis cessation.