The Japanese Journal of Clinical Dialysis Vol.27 No.1(3)

Theme Diversified Frontier of Dialysis Therapy -- We Can Change
Title Is the time coming where we will need to decide whether or not to introduce dialysis?
Publish Date 2011/01
Author Seiji Ohira Sapporo Kita Clinic
[ Summary ] Decisions on whether or not to initiate dialysis treatment are now a subject which medical providers as well as patients face. This is because while both doctors and patients respect life, quality of life highly valued. From the standpoint of medical providers, we must take into account the practicality of treatment while considering factors which will be in the best interest of the patient. On the other hand, patients are in a position to employ ethics and the right of self-determination granted by the constitution. Considering current economic conditions in Japan, there will be difficulties in making decisions independently. Therefore, we must rely on shared decision making for the time being. Problems will arise with surrogate decisions being made for those patients who lack the ability to make decisions for themselves. For these patients, ethical and legal criteria permiting treatment must be implemented.
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