The Quality of Life of the Chronic Dialysis Patient

Abstract

In the course of every day living, people become ill and society maintains a prescribed set of expectations dealing with the person as a patient. It is to be assumed that the patient will be exempt from the performance of normal social obligations, that he will be exempt from the responsibility of his own state, that he will be somewhat helpless and dependent on others, and finally, that he will either get better and be cured or get worse and die. Many life-extending technological advances in modern medicine have created a departure from this classical “image of the ill’ and, simultaneously, have introduced complex ethical, moral, legal, theological, social and financial questions. During the course of his illness, the patient with chronic renal disease usually experiences at least one crisis episode that requires his admission to a hospital for acute care. Most often such an episode occurs when his kidney function fails to the extent that it will no longer sustain life.

“For mere living is not a good, but living well. Accordingly, the wise man will live as long as he ought, not as long as he can.… He always reflects concerning the quality, and not the quantity, of his life. As soon as there are many events in his life that give him trouble and disturb his mind, he sets himself free.… It is not a question of dying earlier or later, but of dying well or ill. And dying well means escape from the danger of living ill.” Seneca (1)