In nephrology care, many ethical questions arise. Dialysis is a life supporting therapy and in a patient population with increasing age and comorbidities, the question regarding withholding or withdrawal of dialysis often will arise when the treatment is considered futile or cause more harm than benefit for the patient. Supportive and palliative care is necessary early in the disease and will be even more necessary when the patient will not receive dialysis. 

My aim with this research project is to study the decisions with a normative ethical approach. There are several value conflicts that can arise in these decisions regarding introduction or continuation, withholding or withdrawal of dialysis: autonomy, quality of life, the best interest of the patient, doing good and avoiding harm etc. I will study patient participation in the decision, timing and framing as well as the potential room for paternalism in the patient-physician relationship.