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Parents Refusing Dialysis for a 3-Month-Old With Renal Failure
Laurel Willig1, Erin Paquette2, D Micah Hester3
1Division of Nephrology and.
Pediatrics
|March 2, 2018
Summary
A infant with severe kidney damage from posterior urethral valves faced a difficult choice between dialysis and palliative care. The family opted for palliative care, raising ethical questions for medical experts.
Area of Science:
- Pediatric Nephrology
- Medical Ethics
- Bioethics
Background:
- A 3-month-old infant presented with failure to thrive, elevated serum urea nitrogen (95 mg/dL), and creatinine (3.6 mg/dL).
- Diagnostic workup revealed severe bilateral hydronephrosis and posterior urethral valves.
Observation:
- Despite successful surgical intervention (fulguration) for posterior urethral valves, the infant's kidney function did not improve.
- Nephrologists recommended dialysis and future kidney transplantation.
Findings:
- The infant's family declined dialysis and transplant, citing concerns about lifelong suffering and family impact.
- The family requested palliative care exclusively for their child.
Implications:
- This case highlights the complex ethical considerations in pediatric end-stage renal disease when families refuse life-sustaining treatment.
- It necessitates a multidisciplinary approach involving nephrology, bioethics, and critical care to navigate parental autonomy and child welfare.
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