Ethical conflicts and decision making on renal replacement therapy

Abstract

This article aimed to explore whether healthcare professionals perceive ethical conflicts and issues
related to decision making and to highlight the significance of patient involvement in this process.
This is a descriptive cross-sectional study, where 63 professionals from four nephrology services in Rio
de Janeiro were interviewed. Through analysis using Bardin’s technique, two main themes emerged:
1) the decision-making process; and 2) bioethical considerations regarding renal replacement therapy
referral. The findings suggest that decision-making is primarily guided by the principles of beneficence
and non-maleficence, with an emphasis on improving the clinical condition associated with renal failure.
However, there is often a lack of consideration for patient autonomy and participation, and ethical
conflicts and decision-making issues may not always be recognized. Paternalistic attitudes remain
prevalent and strong within the studied population.