Best Interests in Renal Dialysis v1
Research type
Research Study
Full title
How should best interests decisions concerning the initiation of maintenance dialysis for adults be made?
IRAS ID
280705
Contact name
Jordan Parsons
Contact email
Sponsor organisation
University of Bristol
Duration of Study in the UK
1 years, 8 months, 30 days
Research summary
To help inform this research’s broader question of “how should decisions about starting dialysis be made for patients who are unable to decide for themselves?”, this study will explore how these decisions are currently made. The average age of a patient approaching kidney failure is over 65 in the UK, and diseases such as dementia are not uncommon among this group. Dialysis is a very burdensome treatment option which usually requires three clinic visits each week and can leave patients feeling exhausted and at increased risk of infection. As such, it is important that patients who cannot decide for themselves only start dialysis when it is in their best interests (as required by the Mental Capacity Act 2005), otherwise they may suffer disproportionate harm. However, some doctors are concerned that dialysis is overused. My PhD aims overall to contribute to the debate about how decisions regarding starting dialysis for this group can be improved, so that patients receive the most appropriate care. A key step in that work is to undertake an empirical study to examine closely how these decisions are currently made and explore key stakeholder perspectives on those decisions.
To understand how these decisions are currently made, I will speak to healthcare workers, patients, and family/friends/others who are close to patients (and may act as consultees). These conversations will provide a picture of current practice from a range of perspectives and tell me what key stakeholders think is important in these decisions. Some of the participants will be patients who are unable to make their own treatment decisions, and it is important to include them as it is the care of patients like them that we want to understand and improve. The study will also (ideally) involve observations of decision-making meetings to see how discussions take place.
The study will take place for two years across three NHS Trusts – one each in Bristol, Birmingham, and London.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
20/LO/1233
Date of REC Opinion
22 Dec 2020
REC opinion
Further Information Favourable Opinion