Advertisement

Ethical Issues in Hemodialysis

  • Thomas R. McCormickEmail author
Chapter

Abstract

The history of hemodialysis is closely intertwined with the birth of bioethics. In 1960, Belding Scribner’s invention of the arteriovenous shunt offered hope for continuing life for the population with end-stage renal disease that had formerly faced a certain death. Suddenly, there were many patients and limited resources with which to serve them, giving rise to profound ethical questions: who should have access to these resources? How should candidates be selected and by what criteria? This chapter provides a discussion of the ethical quandaries that emerged in establishing continuing treatment for patients with chronic renal failure. The author was privileged to know Dr. Scribner and some of his associates such as Dr. Christopher Blagg, as well as Dr. George Aagaard, former dean of the Medical School, and Dr. John Hogness, former president of the University of Washington. These relationships allowed personal communications regarding ethical issues arising from the newly developed practice of chronic renal dialysis.

Keywords

Bioethics Ethical issues Access to care Addiction as a dual diagnosis Distributive justice Quality of life End-stage renal disease 

References

  1. 1.
    Pietzman SJ. Origins and early reception of clinical dialysis. Am J Nephrol. 1997;17:299–303.CrossRefGoogle Scholar
  2. 2.
    McCormick TR. Scribner-McCormick consultation on early dialysis. Seattle: University of Washington; 1993.Google Scholar
  3. 3.
    Blagg CR. The early history of dialysis for chronic renal failure in the United States: a view from seattle. Am J Kidney Dis. 2007;49(3):482–96.CrossRefPubMedGoogle Scholar
  4. 4.
    Alexander S. They decide who lives, who dies: medical miracle puts moral burden on small committee. Life Magazine, 9 Nov 1962.Google Scholar
  5. 5.
    Childress JF. Who should live when not all can live? Surroundings. 1970;70:339–55.Google Scholar
  6. 6.
    United States Renal Data System, 2014 annual data report: epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, 2014.Google Scholar
  7. 7.
    McCormick TR. Vascular access considerations in IV drug users. Nephrology and vascular surgery summit conference, 18 June 2014.Google Scholar
  8. 8.
    Garner J. The wearable artificial kidney, Columns. Seattle: UW Alumni Magazine University of Washington; 2014.Google Scholar
  9. 9.
    McCormick TR. Ethical issues in caring for patients with renal failure. Am Nephrol Nurses Assoc J (AANN). 1993;20(5):549–55.Google Scholar
  10. 10.
    Sehgal AR, Weisheit C, Miura Y, Butzlaff M, Kielstein R, Taguchi Y. Advance directives and withdrawal of dialysis in the United States, Germany, and Japan. JAMA. 1996;276(20):1652–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Jonsen AR. The birth of bioethics. New York: Oxford Press; 1998.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department Bioethics and Humanities, School of MedicineUniversity of WashingtonSeattleUSA

Personalised recommendations