Myth: Rationing of ESRD treatment is an unavoidable reality
Rationing means implicit or explicit denial of beneficial medical treatment as a result of insufficient resources to provide treatment to all. As a key example for nephrologists, a growing demand for solid organs suitable for transplantation, coupled with a static supply of organ donors, precipitated the current “demand crisis” with waits for a kidney exceeding five years in some communities. While it is only in the arena of transplantation that the United States medical community presently confronts a true rationing dilemma, the remainder of the world is forced to cope with insufficient funding for treatment of all potentially treatable ESRD patients by dialysis. The pragmatic reality is that fewer than one in five people living today would have any chance for ESRD therapy should their kidneys fail. It follows that a cohesive rationing policy should manage both the demand for ESRD therapy as well as the fair allocation of transplantable organs.
- 10.Glover JJ, Moss AH. Rationing dialysis in the United States: possible implications of capitated systems. Adv Renal Replacement Ther. 1998;5:341–349.Google Scholar