| Ethical principles and processes guiding dialysis decision-making. | |
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MedLine Citation:
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PMID: 21896833 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Summary When the US Congress created the End-Stage Renal Disease (ESRD) Program in 1972, it gave physicians the responsibility of determining which patients were "appropriate" for dialysis. Congress provided no guidance on who should be selected or how. Only five years later, Dr. Belding Scribner, the father of chronic dialysis, noted that there was a need for a "deselection committee" because virtually all criteria for dialysis patient selection had been slackened, if not abandoned. In 1991, the Institute of Medicine Committee to Study the Medicare ESRD Program recommended the development of a clinical practice guideline because they noted there were "an increasing number of [dialysis] patients with limited survival possibilities and relatively poor quality of life." In 2000, the Renal Physicians Association and the American Society of Nephrology heeded the Institute of Medicine committee's recommendation and published Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis. In 2010, prompted by a substantial body of new research evidence, the Renal Physicians Association published a second edition of this clinical practice guideline. This article describes the application of the ethical principles of respect for patient autonomy, beneficence, nonmaleficence, justice, and professional integrity, and the ethical process of shared decision-making in making decisions about starting, withholding, continuing, and stopping dialysis with patients and families. It urges examination of medical indications and identifies appropriate limits to shared decision-making when the burdens of dialysis can be predicted to substantially outweigh the benefits. |
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Authors:
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Alvin H Moss |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 6 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-09-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 2313-7 Citation Subset: IM |
Affiliation:
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Center for Health Ethics and Law, West Virginia University, PO Box 9022, Morgantown, WV 26506-9022. amoss@hsc.wvu.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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