Withdrawal from long-term hemodialysis in patients with end-stage renal disease in Taiwan.
J Formos Med Assoc
; 112(10): 589-99, 2013 Oct.
Article
in En
| MEDLINE
| ID: mdl-23768949
ABSTRACT
Withdrawal from dialysis is ethically appropriate for some patients with multiple comorbidities and a shortened life expectancy. Taiwan has the highest prevalence of dialysis patients in the world, and the National Health Insurance (NHI) program offers renal replacement therapy free of charge. In this review, we discuss its current status and many background issues related to withdrawing dialysis from patients with advanced renal failure in Taiwan. Compared with dialysis therapy, the medical resources for hospice care are relatively sparse. Since the announcement of the Statute for Palliative Care in 2000, there has been a gradual improvement in the laws and health polices supporting dialysis withdrawal. Culture and social customs also have a significant impact on the practice of hospice care. Based on current evidence and in accordance with the local environment, we propose recommendations for the clinical practice of dialysis withdrawal and hospice care. There remains a need to expand upon the community-based hospice care and home care systems to better serve patients. In conclusion, there are cross-cultural differences relating to dialysis withdrawal between Taiwan and Western countries. Our experience and clinical recommendations may be helpful for the countries with NHI systems or for the Eastern countries.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Renal Dialysis
/
Hospice Care
/
Withholding Treatment
/
Kidney Failure, Chronic
Type of study:
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Ethics
Limits:
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
J Formos Med Assoc
Journal subject:
MEDICINA
Year:
2013
Document type:
Article
Affiliation country:
Taiwán