In sum, then, dialysis can prolong and save a patient's life, but can also impose significant burdens. Depending on the various side effects and problems associated with the procedure, and depending on how minimal the benefits may be in light of other medical conditions the patient may be struggling with, it can become reasonable, in some cases, to discontinue dialysis. The burdens of hemodialysis can sometimes be lessened by using a different kind of dialysis known as peritoneal dialysis, where fluid is instilled in the abdomen via a permanently positioned catheter and later drained. Peritoneal dialysis can be performed by the patient at home each night.

It's not possible with the limited information we have to draw any moral conclusions about the case of the father who is "sick of it" and wants to stop dialysis. We need further details, such as: What is the reason for his request? Is he experiencing serious complications and significant burdens from dialysis? Does he have other medical problems besides kidney failure? Is he suffering from depression, for which he could be treated?

We should never choose to bring about our own or another's death by euthanasia, suicide or other means, but we may properly recognize, on a case by case, detail-dependent basis, that at a certain point in our struggle to stay alive, procedures like dialysis may become unduly burdensome treatments that are no longer obligatory. In these cases, it's always wise to consult clergy or other moral advisors trained in these often-difficult bioethical issues.

Father Tadeusz Pacholczyk, Ph.D. earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River and serves as the Director of Education at The National Catholic Bioethics Center in Philadelphia. See www.ncbcenter.org.