'At least we do not feel guilty': Managing conflict with families over dialysis discontinuation

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  • When enough is enough: The nephrologist's responsibility in ordering dialysis treatments

    2011, American Journal of Kidney Diseases
    Citation Excerpt :

    Patients' wishes must be weighed against the possibility of initiating treatment inconsistent with professional integrity, as when the burdens of dialysis substantially outweigh the benefits.23,24 Although most studies using hypothetical vignettes show that most patients would want to forgo dialysis therapy in the context of severe dementia or permanent coma,25-31 there are occasions, such as the case discussed earlier, when the patient and/or family demand dialysis that the clinician believes is inappropriate. The clinician is not obligated to provide dialysis in circumstances that are outside the standard of care, such as those listed in Box 1.22

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