Not all elderly patients with ESRD should be offered dialysis

We must be prepared to face the prospect of rationing dialysis. Our own experience shows that many patients who would be expected to be denied dialysis under rationing may not be unhappy with that option. Nonetheless rationing of this therapy should not be instituted without examining all forms of health care. It makes little sense to scrimp on end stage renal care if we continue to expend resources on unproved forms of treatment in other...