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Deciding about dialysis

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Patients and families sometimes struggle with the question of whether dialysis is "worth it." A young woman wrote recently on a website addressing dialysis patients' concerns, "My father has been on dialysis for three years, and he's 62 years old. A few days ago he said he wanted to stop going because he was 'sick of it.' We talked to him and told him that it would hurt us if he did that, but now I'm thinking that maybe I shouldn't have talked him out of it -- this isn't about me and my feelings. This is about what he has to deal with."

When would discontinuing dialysis be a reasonable and morally acceptable choice? Could discontinuing dialysis ever be tantamount to suicide?

While every person is obligated to use ordinary (or proportionate) means to preserve his or her life, no person is required to submit to a health care procedure that he or she has judged, with a free and informed conscience, to provide little hope of benefit or to impose significant risks and burdens.

Weighing benefits and burdens is at the heart of the question of starting, continuing or stopping dialysis. As the U.S. Conference of Catholic Bishops has noted: "We have a duty to preserve our life and to use it for the glory of God, but the duty to preserve life is not absolute, for we may reject life-prolonging procedures that are insufficiently beneficial or excessively burdensome. Suicide and euthanasia are never morally acceptable options."

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