01658nas a2200217   4500000000100000008004100001100001700042700001100059700002100070700002100091700001900112700001700131700001800148700002100166700001700187700001900204700006800223245004000291520109500331022001401426       2017                            d1 aLevin Adeera1 aJha V.1 aRemuzzi Giuseppe1 aMartin Dominique1 aBargman Joanne1 aDavies Simon1 aFeehally John1 aFinkelstein Fred1 aHarris David1 aMisra Madhukar1 aInternational Society of Nephrology Ethical Dialysis Task Force00aEthical issues in dialysis therapy.3 a<p>
Treatment for end-stage kidney disease is a major economic challenge and a public health concern worldwide. Renal-replacement therapy poses several practical and ethical dilemmas of global relevance for patients, clinicians, and policy makers. These include how to: promote patients' best interests; increase access to dialysis while maintaining procedural and distributive justice; minimise the influence of financial incentives and competing interests; ensure quality of care in service delivery and access to non-dialytic supportive care when needed; minimise the financial burden on patients and health-care system; and protect the interests of vulnerable groups during crisis situations. These issues have received comparatively little attention, and there is scant ethical analysis and guidance available to decision makers. In this Health Policy, we provide an overview of the major ethical issues related to dialysis provision worldwide, identify priorities for further investigation and management, and present preliminary recommendations to guide practice and policy.
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