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Wiley InterScience | |||||||||||||||
  Seminars in DialysisVolume 20 Issue 5, Pages 387 - 390 Published Online: 29 Jun 2007 © 2010 Wiley Periodicals, Inc. Published in association with the American Society of Diagnostic and Interventional Nephrology
Abstract | References | Full Text: HTML, PDF (Size: 459K) | Related Articles | Citation Tracking  Ethical Issues in Dialysis Aaron Spital, Series Editor Responding to Requests for Dialysis for Severely Demented and Brain Injured Patients Copyright Journal compilation 2007 Blackwell Publishing Abstract
Nephrologists, like all physicians, need to offer their patients all reasonable treatment options, but only the reasonable options. When dialysis is (or is not) a reasonable option is an important ethical issue. The justification for dialysis, like any life-sustaining treatment, is that it prolongs life for a patient who either wishes to live or, if cognitively impaired, would (in the opinion of others) likely benefit from extending their life. This article focuses on patients with advanced dementia or severe and irreversible brain injury who are no longer capable of enjoying life, and hence gain no benefit from dialysis. I present guidelines for withholding and withdrawing dialysis and offer suggestions designed to help nephrologists avoid causing harm when the patient's family demands that dialysis be performed. | 
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