| [ Summary ] |
A critical problem when discussing the terminal care of patients with end stage renal failure concerns the withdrawal or withholding of dialysis. When maintenance dialysis is withdrawn, the patient will inevitably die within several days. Therefore, it is a serious decision on both the patient and medical side. Although patient self-determination is most respected in the terminal stage, patients often cannot make an appropriate decision by then. So, advance directives (AD) are useful, however, AD related to dialysis, including withdrawals, is not widespread. In order for a dialysis patient to have a dignified end of life, advance care planning (ACP) by a patient, a family member, and a medical team in preparation for a decline in decision making ability is important.In the near future, it might be necessary to reevaluate and revise the "Proposal for the Shared Decision-Making Process Regarding Initiation and Continuation of Maintenance Hemodialysis" by The Japanese Society for Dialysis Therapy. |