Palliative care for patients with end-stage renal disease: experiences from Hong Kong.
As the number of patients with end-stage renal disease continues to grow in Hong Kong, many are opting to be managed conservatively without dialysis. A new service was initiated in Tuen Mun Hospital in 2004 aimed at offering palliative care to dying patients with renal failure. This paper presents retrospective data reflecting our dealings with patients who decided not to initiate or considered discontinuation of dialysis. In total, 107 patients received palliative care from the inception of the new service in August 2004 until July 2006. The findings illustrate that decisions related to initiation or withdrawal of dialysis are often related to personal beliefs and sentiments. Further exploration using qualitative methodology is recommended. The case history expounds a situation in which the patient cannot participate in decision-making concerning treatment options and offers some exploration of the ethical intricacies involved in treating very sick patients with dialysis therapy.
Chan
Chun-hung
CH
Department of Clinical Oncology, Tuen Mun Hospital, New Territories, Hong Kong. chanchunhung1024@yahoo.com.hk
Noble
Helen
H
Lo
Sing-hung
SH
Kwan
Tze-Hoi
TH
Lee
Siu-lan
SL
Sze
Wing-kin
WK
D000328:Adult; D016223:Advance Directives; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006723:Hong Kong; D006801:Humans; D007676:Kidney Failure, Chronic / Q000451:nursing / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D006435:Renal Dialysis