Withdrawal from dialysis: the role of autonomy and community-based values

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
A R Eiser

Abstract

By examining the ethical features of dialysis withdrawal as well as tr transcultural differences in attitudes toward withdrawal, one can have a better understanding of the role of autonomy and community-based values on medical decision-making. Three distinctive patterns of withdrawal are described herein. The first concerns patients suffering from an advanced state of physical or mental decline. When a patient or health care surrogate decision maker requests cessation of therapy because it fails to be beneficial for the patient in his or her totality, the physician should be prepared to cooperate, in accord with beneficence and nonmaleficence as well as autonomy. The second pattern occurs when the patient loses decisional capacity, and the surrogate decision maker makes unreasonable requests for nonbeneficial care. At issue is what constitutes nonmaleficence and beneficence in this setting, the provider and surrogate differing on whether continuing dialysis constitutes beneficence. Such a dilemma can alleviated by community-based consensus guidelines with consent of the patient before losing capacity. The dialysis network is potentially a unit of patient and professional community. In third pattern, the patient's decision to wi...Continue Reading

References

May 1, 1992·Kidney International·B CharraG Laurent
Jan 1, 1992·Law, Medicine & Health Care : a Publication of the American Society of Law & Medicine·B Brody
Jan 1, 1989·American Journal of Nephrology·F K PortC W Ferguson
Jan 2, 1986·The New England Journal of Medicine·S Neu, C M Kjellstrand
Jan 1, 1987·American Journal of Nephrology·M KayeG Low
Dec 13, 1985·JAMA : the Journal of the American Medical Association·R CrawshawC Lobitz
Aug 1, 1994·The Journal of Medicine and Philosophy·L M Fleck
May 26, 1994·The New England Journal of Medicine·G J Annas
Oct 1, 1993·Journal of Personality and Social Psychology·J HaidtM G Dias
Jan 1, 1993·Cambridge Quarterly of Healthcare Ethics : CQ : the International Journal of Healthcare Ethics Committees·D H Johnson

❮ Previous
Next ❯

Citations

Aug 10, 2000·Medical Decision Making : an International Journal of the Society for Medical Decision Making·W D SmuckerK M Coppola
Oct 26, 2018·Hemodialysis International·Shehryar KhanEsther Akinyemi
Feb 8, 2003·Journal of Palliative Medicine·E L SieglerCharles F von Gunten
Nov 1, 2005·Scandinavian Journal of Urology and Nephrology·Risto IkäheimoErkki Lampainen
Mar 10, 1999·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·M S Neff
Aug 1, 1997·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·A R Eiser, D J Seiden

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

The Journal of School Nursing : the Official Publication of the National Association of School Nurses
E Levitt, S Taylor
Arthritis Care and Research : the Official Journal of the Arthritis Health Professions Association
T J Brady
SCI Nursing : a Publication of the American Association of Spinal Cord Injury Nurses
D M Lemke
Current Oncology Reports
Richard Theriault, Karin Hahn
© 2021 Meta ULC. All rights reserved