IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v64y2007i11p2236-2247.html
   My bibliography  Save this article

The value of "life at any cost": Talk about stopping kidney dialysis

Author

Listed:
  • Russ, Ann J.
  • Shim, Janet K.
  • Kaufman, Sharon R.

Abstract

With the trend toward an older, sicker dialysis population in the USA, discussions of ethical issues surrounding dialysis have shifted from concerns about access to and availability of the therapy, to growing unease about non-initiation and treatment discontinuation. Recent studies report treatment withdrawal as the leading cause of death among elderly dialysis patients. Yet, the actual activities that move patients toward stopping treatment often remain obscure, even to clinicians and patients themselves. This paper explores that paradox, drawing on anthropological research among patients over age 70, their families, and clinicians in two California renal dialysis units. It concludes that many older patients sacrifice a sense of choice about dialysis in the present to maintain "choice" as both value and possibility for the future. Even so, patients desire more information and communication, provided earlier in their illness, about prognosis, how long they can expect to be on dialysis, and what the impact of the treatment will be on their daily lives. That, with time, there is a transition to be made from dialysis as "treatment" to end of life care could be better explained and managed to alleviate patients' confusion and unneeded isolation.

Suggested Citation

  • Russ, Ann J. & Shim, Janet K. & Kaufman, Sharon R., 2007. "The value of "life at any cost": Talk about stopping kidney dialysis," Social Science & Medicine, Elsevier, vol. 64(11), pages 2236-2247, June.
    • Handle: RePEc:eee:socmed:v:64:y:2007:i:11:p:2236-2247
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(07)00061-5
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Stanton, Jennifer, 1999. "The cost of living: kidney dialysis, rationing and health economics in Britain, 1965-1996," Social Science & Medicine, Elsevier, vol. 49(9), pages 1169-1182, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Llewellyn, Henry & Low, Joe & Smith, Glenn & Hopkins, Katherine & Burns, Aine & Jones, Louise, 2014. "Narratives of continuity among older people with late stage chronic kidney disease who decline dialysis," Social Science & Medicine, Elsevier, vol. 114(C), pages 49-56.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. MacKillop, Eleanor & Sheard, Sally, 2018. "Quantifying life: Understanding the history of Quality-Adjusted Life-Years (QALYs)," Social Science & Medicine, Elsevier, vol. 211(C), pages 359-366.
    2. Chang, Sungwon & Gholizadeh, Leila & Salamonson, Yenna & DiGiacomo, Michelle & Betihavas, Vasiliki & Davidson, Patricia M., 2011. "Health span or life span: The role of patient-reported outcomes in informing health policy," Health Policy, Elsevier, vol. 100(1), pages 96-104, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:64:y:2007:i:11:p:2236-2247. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.