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Inside E Street

Dialysis Dilemma

Practical and ethical considerations of the dialysis dilemma

Dialysis is a life-sustaining treatment for nearly half a million Americans with kidney disease.  It’s also big business, with more than four thousand privately owned dialysis centers dotting strip malls throughout the nation.

See also: One kidney, two hearts

Inside E Street takes a look at recently revised guidelines issued by the Renal Physicians Association which call into question the wisdom of dialysis for elderly kidney patients who also suffer from other maladies, such as heart disease or cancer.  The guidelines suggest frank discussions between doctors, patients and families—conversations that in many ways mirror the broader debate over the future of healthcare in America.

Lark McCarthy talks to Professor Robert M. Veatch, Medical Ethicist at the Kennedy School of Ethics at Georgetown University and Andrew Howard, MD, Clinical Nephrologist and past president of the National Kidney Foundation.  Professor Veatch believes that physicians have no business advising patients against dialysis while Dr. Howard is a strong supporter of the Renal Physicians Association guidelines.  Dr. Howard describes his group practice as being particularly dedicated to advising patients with ESRD (End Stage Renal Disease) that dialysis is unlikely to enhance or extend their lives.

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