Valerie A. Luyckx , Dominique E. Martin , Mohammed Rafique Moosa , Aminu K. Bello , Ezequiel Bellorin-Font , Tak Mao Chan , Rolando Claure-Del Granado , Walter Douthat , Somchai Eiam-Ong , Felicia U. Eke , Bak Leong Goh , Vivekanand Jha , Evie Kendal , Adrian Liew , Yewondwossen Tadesse Mengistu , Elmi Muller , Ikechi G. Okpechi , Eric Rondeau , Manisha Sahay , Michele Trask , Tushar Vachharajani
{"title":"发展终末期肾病护理的伦理框架:从实践到政策","authors":"Valerie A. Luyckx , Dominique E. Martin , Mohammed Rafique Moosa , Aminu K. Bello , Ezequiel Bellorin-Font , Tak Mao Chan , Rolando Claure-Del Granado , Walter Douthat , Somchai Eiam-Ong , Felicia U. Eke , Bak Leong Goh , Vivekanand Jha , Evie Kendal , Adrian Liew , Yewondwossen Tadesse Mengistu , Elmi Muller , Ikechi G. Okpechi , Eric Rondeau , Manisha Sahay , Michele Trask , Tushar Vachharajani","doi":"10.1016/j.kisu.2019.11.003","DOIUrl":null,"url":null,"abstract":"<div><p><span>Ethical issues relating to end-stage kidney disease (ESKD) care are increasingly being discussed by clinicians and ethicists but are still infrequently considered at a policy level or in the education and training of health care professionals. In most lower-income countries, access to </span>kidney replacement therapies such as dialysis is not universal, leading to overt or implicit rationing of resources and potential exclusion from care of those who are unable to sustain out-of-pocket payments. These circumstances create significant inequities in access to ESKD care within and between countries and impose emotional and moral burdens on patients, families, and health care workers involved in decision-making and provision of care. End-of-life decision-making in the context of ESKD care in all countries may also create ethical dilemmas for policy makers, professionals, patients, and their families. This review outlines several ethical implications of the complex challenges that arise in the management of ESKD care around the world. We argue that more work is required to develop the ethics of ESKD care, so as to provide ethical guidance in decision-making and education and training for professionals that will support ethical practice in delivery of ESKD care. We briefly review steps that may be required to accomplish this goal, discussing potential barriers and strategies for success.</p></div>","PeriodicalId":48895,"journal":{"name":"Kidney International Supplements","volume":"10 1","pages":"Pages e72-e77"},"PeriodicalIF":19.3000,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.kisu.2019.11.003","citationCount":"10","resultStr":"{\"title\":\"Developing the ethical framework of end-stage kidney disease care: from practice to policy\",\"authors\":\"Valerie A. Luyckx , Dominique E. Martin , Mohammed Rafique Moosa , Aminu K. 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These circumstances create significant inequities in access to ESKD care within and between countries and impose emotional and moral burdens on patients, families, and health care workers involved in decision-making and provision of care. End-of-life decision-making in the context of ESKD care in all countries may also create ethical dilemmas for policy makers, professionals, patients, and their families. This review outlines several ethical implications of the complex challenges that arise in the management of ESKD care around the world. We argue that more work is required to develop the ethics of ESKD care, so as to provide ethical guidance in decision-making and education and training for professionals that will support ethical practice in delivery of ESKD care. 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Developing the ethical framework of end-stage kidney disease care: from practice to policy
Ethical issues relating to end-stage kidney disease (ESKD) care are increasingly being discussed by clinicians and ethicists but are still infrequently considered at a policy level or in the education and training of health care professionals. In most lower-income countries, access to kidney replacement therapies such as dialysis is not universal, leading to overt or implicit rationing of resources and potential exclusion from care of those who are unable to sustain out-of-pocket payments. These circumstances create significant inequities in access to ESKD care within and between countries and impose emotional and moral burdens on patients, families, and health care workers involved in decision-making and provision of care. End-of-life decision-making in the context of ESKD care in all countries may also create ethical dilemmas for policy makers, professionals, patients, and their families. This review outlines several ethical implications of the complex challenges that arise in the management of ESKD care around the world. We argue that more work is required to develop the ethics of ESKD care, so as to provide ethical guidance in decision-making and education and training for professionals that will support ethical practice in delivery of ESKD care. We briefly review steps that may be required to accomplish this goal, discussing potential barriers and strategies for success.
期刊介绍:
Kidney International Supplements is published on behalf of the International Society of Nephrology (ISN) and comes complimentary as part of a subscription to Kidney International. Kidney International Supplements is a peer-reviewed journal whose focus is sponsored, topical content of interest to the nephrology community.