| Theme | Dialysis Therapy in Aging Society -- Current Status and Involved Problems | |
|---|---|---|
| Title | Problems with discontinuation of dialysis | |
| Publish Date | 2007/07 | |
| Author | Kazuyoshi Okada | Division of Nephrology and Endocrinology, Department of Medicine, Nihon University School of Medicine |
| [ Summary ] | In situations in which there are neither guidelines for the discontinuation of dialysis nor prior legally binding, written consent for “dignified death” physicians can be accused of homicide if they discontinue life sustaining treatment. Although the discontinuation of dialysis can help the patient die calmly and with dignity, it may be considered homicide unless the patient's condition suggests that death will occur in approximately one week, whether or not dialysis is performed. Physicians are responsible for helping terminally ill patients live the balance of their lives satisfactorily by providing them with medical care in accordance with their living wills. The main point is to adopt strict guidelines for physicians on medical teams, so they may function effectively when deciding whether they should intentionally allow a patient to die after sufficient evaluation of the prognosis rather than simply following the patient's, family's or medical requests. The decision to discontinue dialysis should be taken seriously, and practical guidelines should be established through discussion with appropriate parties, including lawyers, on requirements for discontinuing life sustaining treatment and other care methods. We have to consider “dialysis postponement” with a control of transfusion volume at present. |
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