Ethical Considerations in the Care of Dialysis Patients: The New Paradigm

The paradigm shift in the ethics of dialysis patient care is away from disease-oriented care toward patient-centered care. This chapter will address the following ethical questions: Who should and should not receive dialysis? On what basis should decisions about renal replacement therapy and modality be made? When should a time-limited trial of dialysis be used? When should palliative care consultation be considered? When should palliative dialysis be offered? When should stopping dialysis be considered? How should a nephrologist respond to a patient's request to stop dialysis? How should a patient who stops dialysis be treated? When should a dialysis patient be referred to hospice?