Euthanasia in dialysis

Abstract

When a dialysis patient is lacking goals in life, when the wish for health and well-being is only a dream, and when the hope to achieve less suffering is small, the patient may decide to commit suicide. Generally, nephrologists are asked to assist these patiants in giving death, thus facilitating euthanasia. Euthanasia can be active (commissioned) or passive (omitted), and the interruption of dialysis treatment is a typical case of omitted euthanasia. Three different cases of dialysis patients requesting euthanasia are here reported. The cases emphasize how different can be the correlation between the control of symptoms by hemodialysis and the patients' own perception of their life quality. Hospice treatment in dialysis patients who are determined to end their lives can be interpreted, according to many authors, as the palliative continuity of care from dialysis to a “smooth” end of life. Nevertheless, health operators should keep in mind that palliative care and hospice treatment should be seen as the last setting for patients who freely wish to leave dialysis towards a “smooth” death. (Bioethics)