Palliative Nephrology: Time for New Insights

In 1971, Belding Scribner, the father of maintenance dialysis, recognized the complexities of dialysis decision making, anticipating both the importance of deciding not to treat and the difficulty deciding when to stop.1 As Scribner recounted to Renée Fox in the book The Courage to Fail: A Social View of Organ Transplants and Dialysis, "Selection … will take the form of advising the patient and his family that we don't think this treatment is right for him. And then for some patients, there will be the usually agonizing decision of whether or not to terminate treatment."1(p 373)

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