case study: A 40-year-old woman has kidney disease and requires dialysis to surv
ID: 3489460 • Letter: C
Question
case study: A 40-year-old woman has kidney disease and requires dialysis to survive. She refuses the dialysis treatment because she is scared and believes it is too invasive. Her doctor describes the treatment to her in detail, explains that there are no alternatives that would be helpful for her condition, and tells her that she may die without dialysis. She is competent to make decisions about her treatment. She has a 15-year-old daughter who lives at home with her. The doctor feels very strongly that she should receive dialysis, but she continues to refuse despite repeated attempts to obtain her consent.
Respond to the following in a 100- to 300-word post:
What can the doctor do to treat this patient?
Do you think the doctor should respect the patient's autonomy in this life-threatening situation? Why or why not?
Do you believe the patient is making an informed decision? Is there anything else the doctor can do to inform the patient about the risks and benefits of treatment?
Do you think the daughter should be considered in this case? Should she be involved in discussions?
Explanation / Answer
Dialysis as a medical procedure can be defined as the process of purification of blood when kidneys aren't able to perform this function . it is often expensive and time consuming and requires major changes in lifestyle and food habits.
Initially the doctor can keep the patient on certain medications to treat the symptoms of kidney disease /failure such as anaemia management, changes to diet with salt restriction etc. If the patient still refuses a dialysis other newer but expensive options such as kidney transplant, artificial kidney, mesh fibre kidney can be discussed with the patient.
No, according to what is mentioned in the case study the patient isn't making an informed decision. Taking friends and families opinion and advice and discussing this major life decision with them is a must. Also asking the doctor about the procedure and it's risks and benefits before making a quick, careless decision is necessary. Also the doctor can counsel the patient about the risks and benefits. Also in case of any anxiety or irrational fearful beliefs about the procedure should be dealt with
Yew, the daughter being the only person in her family according to the information mentioned in the case study should be considered and made a part of the decision. This will greatly help alleviate any anxiety and fears in the patient. Also the main cause of refusal for dialysis by the patient can be understood if the daughter us called for the decision and made a part of it.
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