Consider this patient scenario: An elderly man who has been on renal dialysis for many years is now unsure about wanting life-sustaining dialysis but continues treatment because he feels this is what his family wants. The patient is wheelchair bound, frail, and in pain. He has told his doctor he hopes to die in his sleep. What should the doctor do? Clearly, we need more information. But, what facts of the case are important to know, and how should we weigh them so we feel confident in offering a recommendation that is ethically sound? Clinical situations that raise ethical questions are a challenge to navigate. Often, there are multiple clinical facts to consider. In addition, patient values and preferences and the concerns and values of family must b
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