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All elderly patients should be offered dialysis

  • Editorial Comment
  • Published:
Geriatric Nephrology and Urology

Summary

  1. 1.

    Physicians practise age rationing in dialysis.

  2. 2.

    There is no medical, quality of life, economical or moral argument for rationing out the old from dialysis.

  3. 3.

    Rationing by age is unjust, unethical, and immoral.

  4. 4.

    Governments will increase their pressure on physicians to limit treatment.

  5. 5.

    There is no reasonable way to ration dialysis.

  6. 6.

    Physicians are therefore likely to follow the path of least resistance, and let age be the rationing tool under various subterfuges.

  7. 7.

    Such a scheme will wipe out medicine as a profession and make physicians into body technicians.

  8. 8.

    To avoid this, the fifth principle, the duty of advocacy, needs to be established as an important professional duty of physicians.

  9. 9.

    To avoid the dilemma of torturing dialysis patients who do badly, all dialysis must begin with a 30-day trial, at the end of which time dialysis will either be continued if the patient is doing well, or discontinued if not.

  10. 10.

    To ease the problem of discontinuation of dialysis later, patients must let their wish be known of what to do if incompetent, thus advance directives.

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Authors and Affiliations

  1. University of Alberta, Canada

    Carl Kjellstrand (Professor of Medicine & Bioethics)

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  1. Carl Kjellstrand
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Kjellstrand, C. All elderly patients should be offered dialysis. Geriatric Nephrol Urol 6, 129–136 (1997). https://doi.org/10.1007/BF00249628

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