Paliatívna medicína a liečba bolesti 2e/2019

Ethical aspects of providing dialysis treatment in frail and dying patient

While in the past the access to dialysis treatment was limited, it is currently available to virtually everyone in developed countries. However, in frail and dying patients, dialysis treatment may in some cases be considered futile and causing unnecessary suffering to the patient. This poses an ethical problem of how to approach such a patient. The risk-benefit ratio of such treatment should be examined carefully and the decision should be made in cooperation with the patient and his/her family – after proper explanation of the options, the risks of the treatment and the expected prognosis. The decision should respect the patient‘s autonomy. In case of a decision not to start or to terminate dialysis treatment, the patient should be given maximum conservative management and provided with all available palliative care.

Keywords: dialysis treatment, futile treatment, frail patient, dying patient, patient autonomy