No Treatment as an Option
No treatment is an important option for some patients. You have the right not to start dialysis if you feel that the burdens outweigh the benefits. Each person’s situation is different.
For example, an elderly dementia patient in a nursing home who needs help to get out of bed may not benefit from dialysis. The dialysis treatment may cause unnecessary suffering and pain. If dialysis increases suffering and doesn’t improve the patient’s quality of life, supportive care is a better option. With supportive care, patients continue to see their provider. The goal of interventions is to reduce pain and keep the patient as comfortable as possible.
If you feel that you can’t make the decision, your surrogate can make it for you. Your advanced directive or durable power of attorney identifies the person who has your permission to act on your behalf. Make sure you talk to this person about your wishes. Give clear directions about any treatment that you want or don’t want.
When making decisions about your healthcare, talk to people you trust. Your provider, religious clergy, social worker, psychologist, or another healthcare worker can help. Talk about how you feel. Ask as many questions as you need.
If your provider feels that you have an emotional reason for deciding not to pursue treatment, he will refer you to a psychologist or to counseling (or both).
Palliative care is available in most large hospitals and in some outpatient clinics. In some geographical areas, home visits are available. Ask your provider for a referral or go to the Palliative Care Provider Directory to search.