| Theme | The management of the end of life in hemodialysis patients | |
|---|---|---|
| Title | Withholding and withdrawal of dialysis in nephrology hospital -- a role of ethics committee | |
| Publish Date | 2018/09 | |
| Author | Kazuyo Teshima | Nagasaki Kidney Hospital |
| Author | Takashi Harada | Nagasaki Kidney Hospital |
| Author | Satoshi Funakoshi | Nagasaki Kidney Hospital |
| [ Summary ] | End-of-life care for patients undergoing dialysis is notably different from that provided to the general population because how they prepare for impending death is strongly related to how smoothly they can quit maintenance dialysis. With a rapidly aging population and a greater number of elderly individuals in our society, withholding dialysis may need to be considered. Thus, the Japanese Society of Dialysis Treatment had established "Proposal for the Shared Decision-Making Process Regarding Initiation and Continuation of Maintenance Hemodialysis" in 2014, listing guidelines for withholding or withdrawing from dialysis. Between 2008 and 2018 we encountered 14 cases of withholding or withdrawing from dialysis at our hospital: 5 patients withheld and 9 withdrew from dialysis. Reasons for refusal to receive dialysis treatment (either by the patient or the family) included dementia in 7 patients and cancer in 4, in addition to other reasons. In our facility, we discussed ethical issues regarding the withholding or the withdrawing in our ethics committee even the will of the patients were clear. |
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