title: The option to withdraw from chronic dialysis treatment.
abstract: This multidisciplinary discussion focuses on the case of a young diabetic woman who chose to stop chronic hemodialysis during a long and complicated illness. The perspective presented here include an academic lawyer's view of such medical decisions; a hospital chaplain's view of the religious framework for end-of-life situations; a clinical psychiatrist's considerations when consulted to evaluate patients in such straits; a transplant nurse's view of the opportunities for personal interaction that such clinical situations present; and a renal social worker's approach to chronic illness, advance directives, and death in the dialysis patient population. The discussion is intended to address objectively some important issues associated with death in this population, aimed at increasing our willingness to discuss these issues more openly with patients and with our colleagues.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0364, USA.
authors.forename: R D
authors.initials: RD
authors.lastname: Swartz
authors.forename: E
authors.initials: E
authors.lastname: Perry
authors.forename: C
authors.initials: C
authors.lastname: Schneider
authors.forename: T
authors.initials: T
authors.lastname: Burdette
authors.forename: G
authors.initials: G
authors.lastname: Curtis
authors.forename: M
authors.initials: M
authors.lastname: O'Neil
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000523:psychology; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D026684:Personal Autonomy; D012068:Religion and Medicine; D006435:Renal Dialysis / Q000451:nursing / Q000523:psychology*; D013315:Stress, Psychological; D016312:Treatment Refusal / Q000331:legislation & jurisprudence / Q000523:psychology*