Ethical aspects of withdrawing/withholding renal replacement therapies on patients in acute renal failure in an intensive care unit.
The majority of patients being treated for acute renal failure in intensive care units have multiple medical problems. Accordingly, the withdrawal of renal replacement therapies should be considered as part of a general decision about whether to initiate or continue with treatment per se. Several guidelines on withdrawing and withholding therapy have been produced and some common themes emerge: concerns to avoid euthanasia, potential for benefit, patient consent (shared decision-making), team consensus/decision-making, and the provision of appropriate palliative care and resource implications. Each of these is considered in turn, although the word limit for this paper does not permit detailed exposition.
Draper
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The Centre for Biomedical Ethics, The Department of Primary Care and General Practice, Birmingham University, Edgbaston, UK. h.draper@bham.ac.uk
D058186:Acute Kidney Injury / Q000401:mortality / Q000628:therapy*; D003657:Decision Making; D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D010166:Palliative Care / Q000331:legislation & jurisprudence / Q000592:standards; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D017410:Practice Guidelines as Topic; D017582:Renal Replacement Therapy / Q000592:standards*; D006113:United Kingdom; D028761:Withholding Treatment / Q000331:legislation & jurisprudence / Q000592:standards*