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Should dialysis be offered to all elderly patients?
1Baystate Medical Center and Tufts University, Springfield, Mass., USA.
Blood Purification
|February 10, 2015
Summary
Nephrologists should offer dialysis only when beneficial, prioritizing patient well-being over automatic treatment. Shared decision-making is crucial for appropriate initiation and withdrawal from dialysis.
Area of Science:
- Nephrology
- Medical Ethics
Background:
- Nephrologists frequently encounter decisions regarding dialysis initiation and withdrawal.
- A common practice is offering dialysis for end-stage renal disease (ESRD) irrespective of risk-benefit analysis.
Purpose of the Study:
- To advocate for a treatment approach where nephrologists prescribe dialysis only when indicated and beneficial.
- To emphasize the ethical obligation to avoid treatments that offer more harm than benefit.
Main Methods:
- The study presents a position based on clinical judgment and ethical considerations.
- It references national guidelines on shared decision-making in renal replacement therapy.
Main Results:
- Dialysis should not be initiated if the patient is unlikely to benefit.
- Patients have the right to refuse treatment but cannot demand ineffective interventions.
Conclusions:
- Shared decision-making is the cornerstone for managing dialysis initiation and withdrawal.
- This approach aligns with the principle of providing beneficial and effective patient care.
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