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Post ethics and dialysis
Author: hstuch
Date: Aug 11, 2011 6:41 am
At huge financial loss, our hospital has offered dialysis to a small population of uninsured patients, sometimes for many years. The current fiscal crisis has led to a decision to stop this service. Patients will be dialysed in the hospital as needed, will be helped to find any available support upon discharge but will no longer be able to return for routine dialysis.
The palliative care service has been asked to see these patients, advise about goals and address symptoms. The patients want to continue dialysis and view our discussion as coercive. We want to help the patient and families but are conflicted about the use our service should be used this way. Anyone have any insights?
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Re:ethics and dialysis (by babcc on 08/11/2011)
My question to the nephrologist is why is dialysis even being offered if they know that it cannot be done outside of the hospital? We put this on the nephrologist to determine if they are going to start dialysis, then they will have to offer the free service outside of the hospital. Most of them have their own dialysis centers. I do not believe it is ethical for palliative care to be put in the situation that you describe, but you can be the one to recommend how it should be handled.

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