Dialysis and conservative management: ethical and deontological issues in the decision-making process

Hemodialysis, peritoneal dialysis and conservative care are nowadays the main treatment options to help persons suffering from advanced kidney diseases. The Authors intend to deal with ethical issues concerning decision-making process about these treatments. Data confirmed that among patients who have the choice between two medically accepted and available options that are believed to have a chance of promoting the patient’s welfare some patients prefer a treatment option; the other option is the treatment of choice for the others. In decision-making process, a prominent role must be given to patient’s values and his/her judgment about the impact of the treatment options on his/her quality of life, in personal assessment of benefits and burdens. Thus, share decision-making is the recommended model for decision-making in this context; the physician has the important role to guide this process, ascertaining the patient’s preferences and personal values.