Authors: Murtagh, Fliss E.M.¹; Spagnolo, Antonio G.²; Panocchia, Nicola³; Gambaro, Giovanni⁴

Source: Progress in Palliative Care, Volume 17, Number 4, August 2009 , pp. 179-185(7)

Publisher: Maney Publishing

Abstract:

Several key questions help to clarify the evolving debate concerning management of end-stage renal disease and withdrawal of dialysis. First, what is the evidence about survival, quality of life, and course of illness, following conservative management or dialysis withdrawal? Second, what criteria are used for deciding on conservative management or withdrawing dialysis, and how are these criteria justified? Third, who should make the decision and how should it be reached, particularly when there is cognitive impairment and the patient cannot make the decision for themselves? Decision criteria, the evidence, and who decides are each considered in this review.

Keywords: DIALYSIS WITHDRAWAL; CONSERVATIVE MANAGEMENT; END-STAGE RENAL DISEASE

Document Type: Review Article

DOI: http://dx.doi.org/10.1179/096992609X12455871937143

Affiliations: 1: Department of Palliative Care, Policy and Rehabilitation, King's College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK;, Email: fliss.murtagh@kcl.ac.uk 2: Department of Educational Sciences, University of Macerata, Italy, and Board of Directors, Center for Bioethics, Catholic University, School of Medicine, Rome, Italy 3: Department of Surgical Sciences, Section of Hemodialysis, Gemelli University Hospital, Catholic University, School of Medicine, Renal Program, Rome, Italy 4: Division of Nephrology and Dialysis, Columbus-Gemelli University Hospital, Catholic University, School of Medicine, Renal Program, Rome, Italy

Publication date: 2009-08-01

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