The Japanese Journal of Clinical Dialysis Vol.23 No.8(4)

Theme Dialysis Therapy in Aging Society -- Current Status and Involved Problems
Title The decision to withhold dialysis in elderly patients with renal failure
Publish Date 2007/07
Author Akira Ito Department of Internal Medicine, Masuko Memorial Hospital
Author Fumi Kato Department of Internal Medicine, Masuko Memorial Hospital
Author Takunobu Morihiro Department of Internal Medicine, Masuko Memorial Hospital
Author Chika Kondo Department of Internal Medicine, Masuko Memorial Hospital
Author Miho Shinoda Department of Internal Medicine, Masuko Memorial Hospital
Author Tsuneo Ueki Department of Urology, Masuko Memorial Hospital
[ Summary ] Non-introduction of dialysis is one method for life sustenance in terminal care, and currently an important issue. The number of cases in which dialysis is not introduced will increase as the approach becomes recognized and is discussed further to reach an agreement in society. Regarding terminal care, up to now, prudent measures have been taken to deal with specific cases (terminal cancer, consciousness disturbance, dementia etc). But considering the current medical context, the need to establish guidelines on how to treat terminal patients is increasing. In Japan, the prevailing ideas mean that in many cases how to treat a patient is decided not by the patient's own will but by agreement between the patient's family and the medical staff. When establishing guidelines, especially in the case of elderly people, it is very important to keep the word “dignity” in mind to show respect for the patient's self-recognition of achievements and accomplishments in life as well as to emphasize human rights.
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