Discussion of Paper by Rutten
In my discussion I will start briefly summarizing the main points of Rutten’s paper. I will then comment on some specific questions. In his introduction, Rutten made three important points that are relevant for the further evaluation: (1) dialysis is life-saving; (2) dialysis is very costly; and (3) technology is only gradually advancing. In his paper Rutten thoroughly reviews the macroeconomic impact of dialysis with figures for direct costs and gives data on growth of programmes in diffferent areas of the world. The most obvious benefit of dialysis is the number of life-years saved - but it should somehow be corrected for poor quality of life. Relaxation of the egalitarian principle that healthy life is of equal intrinsic value to everyone may be necessary in view of the limitation of resources, which involves complex ethical questions.
KeywordsESRD Patient Chronic Dialysis Transplantation Unit Analgesic Nephropathy Chronic Dialysis Patient
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