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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on April 06, 2007, 05:04:49 PM

Title: Ending dialysis raises some tough questions
Post by: okarol on April 06, 2007, 05:04:49 PM
Ending dialysis raises some tough questions

By BILL KETTLER
Mail Tribune, South Oregon

When a cancer patient stops chemotherapy or radiation, most people can accept that decision, but opinion is more divided on stopping treatments such as dialysis that are perceived as less painful, says medical ethicist Dr. Susan Tolle.

People are generally sympathetic when someone stops treatments that are in themselves "a profound burden" and offer little hope of extending life, said Tolle, director of the Center for Ethics in Health Care at Oregon Health & Science University.

Many people are much more uncomfortable when someone ends a treatment such as dialysis, which is perceived as life-extending with relatively few painful side effects.

"The question is whether (stopping dialysis) is letting nature take its course, or somehow not working to sustain life as you're obligated to do," she said.

Tolle said for people who have serious multiple medical problems, "dialysis is more painful than most people realize."

"The sicker you are the worse you feel with dialysis," she said.

Tolle said research indicates 15 percent of all people on dialysis at any given moment will discontinue it voluntarily. She said that decision to stop dialysis is not all that different from a cancer patient's decision to reject a fourth round of painful chemotherapy to spend one's final days at home in peace.

Oregon leads the nation in the percentage of people who die at home, rather than in a nursing home or hospital. Tolle said the majority of nursing home residents say "no" to some kind of treatment at the end of life.

Many leave written instructions not to be revived if they suffer a stroke or heart attack. Others might even refuse oral antibiotics or just stop eating and drinking.

"Most people with advanced chronic diseases make a plan to limit (treatment) at the end," she said.

"It's common. It's not shameful," she said. "It's what Oregonians do, quietly and privately."

Reach reporter Bill Kettler at 776-4492 or e-mail bkettler@mailtribune.com.

http://www.mailtribune.com/archive/2007/0406/local/stories/decision-side.htm
Title: Re: Ending dialysis raises some tough questions
Post by: goofynina on April 07, 2007, 01:53:30 PM
I know we have discussed this very topic before here, and i believe a patient has the right to stop dialysis if he/she wants to.  just my  :twocents;
Title: Re: Ending dialysis raises some tough questions
Post by: Sluff on April 08, 2007, 06:03:53 AM
This article points out a very real statistic. Cancer patients can quit cancer treatments and it is excepted. Why would a dialysis patients decision to stop treatment not be an accepted decision.
Title: Re: Ending dialysis raises some tough questions
Post by: boxman55 on April 10, 2007, 05:47:56 PM
acceptance from whom, Sluff if I decided one day I want to stop and I made peace with my God I don't think I would care what everyone thought. Your family would be there and that is all I would need. Don't get me wrong we still have a fishing trip to do.--Boxman55
Title: Re: Ending dialysis raises some tough questions
Post by: thegrammalady on April 10, 2007, 06:22:45 PM
we had a gal at my clinic who made the same decision. she said she was just worn out.
Title: Re: Ending dialysis raises some tough questions
Post by: Sluff on April 10, 2007, 06:32:26 PM
Just society in general -Boxman ;)
Title: Re: Ending dialysis raises some tough questions
Post by: George Jung on April 10, 2007, 06:48:24 PM
I whole heartedly believe that it is a persons decision no matter what the chronic illness may be.  Who can say that it is "acceptable" for this group of people but not that group of people.  Every individual has his/her own set of circumstances and what right does anyone have to judge?
Title: Re: Ending dialysis raises some tough questions
Post by: Sluff on April 10, 2007, 07:25:00 PM
George,

I am in total

agreement with you.

 :thumbup;