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Competent Patients, Incompetent Decisions

Ian Kerridge, BA, BMed(Hons), MPhil; Michael Lowe, BMed; and Kenneth Mitchell, MSc, MEd, PhD, FAPss
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From the University of Newcastle and John Hunter Hospital, Newcastle, New South Wales, Australia. Acknowledgments: The authors thank Dr. Paul Trevillian for his clinical and critical guidance. Current Author Addresses: Drs. Kerridge, Lowe, and Mitchell: Locked Bag No. 1, Newcastle Mail Region Center, New South Wales, Australia 2310.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1995;123(11):878-881. doi:10.7326/0003-4819-123-11-199512010-00011
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We describe the epidemiologic aspects of dialysis withdrawal, the role of patient autonomy and of medical beneficence in the decision to discontinue dialysis, and the conditions under which limits may be placed on patient autonomy. A case is presented that provides insight into the issues involved in making such decisions and that should provoke further discussion on the role of “medical guidelines” for dialysis refusal and withdrawal.





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