Table 1.

Situations in which it is ethically appropriate to withhold or withdraw dialysis

• Patients with decision-making capacity who, being fully informed and making voluntary choices, refuse dialysis or request that dialysis therapy be discontinued
• Patients who no longer possess decision-making capacity who previously have indicated refusal of dialysis therapy in an oral or written advance directive
• Patients who no longer possess decision-making capacity and whose properly appointed legal agents/surrogates refuse dialysis therapy or request that it be discontinued
• Patients with irreversible profound neurologic impairment such that they lack signs of thought, sensation, purposeful behavior, and awareness of self and environment
  • Reproduced with permission from references 1 and 2.