SELECTED REFORM RESPONSA
chose the appropriate path for herself. Now as she is suffering from end stage renal disease, as well as congestive heart failure, it is not a question of saving her life, but possibly prolonging it at the expense of her dignity and with some pain both physical and psychological.
This patient rejected dialysis while living independently at home; and should not have dialysis imposed upon her now that she is dependent upon the services of a nursing home. Her attitude has led to a full, long life. Additional medical attention which she does not wish should not be forced on her; it is only likely to shorten her life. The physician has done his duty by suggesting the treatment. The patient knows that she is close to the end of her life- with or without the treatment- and is not obligated to accept the suggestion.
November 1988