title: [Ethics consultation unit in nephrology (UCEN): review of 10 years of operation in the Grenoble area].
abstract: The existence of an ethics consultation unit in nephrology (UCEN) gives to the nephrologist the collegiality required to meet the difficulties of therapeutic choice on a legislative level, particularly in indications of stop dialysis. The discussion conducted, outside the emergency, is guided by a tool for reflexion that details successive steps necessary to the identification of elements required for decision-making. Thanks to complementary skills provided by the participants and training acquired, the UCEN can approach other ethic issues encountered during practice such as contrindication for a kidney transplantation or maintenance of conservative treatment, or performing invasive procedures on patients refusing transfusion. Propositions are not always relevant due to opposition or ambivalence of some patients, their relatives, an external or disagreements between teams or a mismatch between the technical and the patient's condition. These non-conformities decrypted always have an explanation, sometimes they are understood and accepted by the teams, and sometimes they became source of regrets when they extend life in very poor conditions. The UCEN, if it does not solve every single point, remains a place and a time of sharing that face difficult situations, help the nephrologist positioning himself on maintaining treatments that were first to avoid and prevent the realization of unreasonable acts and accept their limits.
authors.affiliation: Pôle Digidune, clinique universitaire de néphrologie, hôpital Nord, CHU de Grenoble, boulevard de la Chantourne, 38700 La Tronche, France. JMaurizi@chu-grenoble.fr
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Maurizi Balzan
authors.forename: Olivier
authors.initials: O
authors.lastname: Moreaud
authors.forename: Pedro
authors.initials: P
authors.lastname: Palacin
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Truche
authors.forename: Philippe
authors.initials: P
authors.lastname: Zaoui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D033061:Ethics Consultation; D006801:Humans; D008875:Middle Aged; D009398:Nephrology / Q000941:ethics*; D006435:Renal Dialysis / Q000941:ethics*