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GW’s Dr. Katherine Chretien Discusses Dialysis in Health Affairs Narrative Matters Essay

WASHINGTON — A Narrative Matters essay, written by Katherine Chretien, M.D., associate professor of Medicine at The George Washington University School of Medicine and Health Sciences, was published in the April 2011 issue of Health Affairs. 

In her essay, titled “Driven To Dialysis? A Very Sick Nonagenarian Develops Kidney Failure,” Dr. Chretien examines the factors involved in a doctor’s decision to recommend or not recommend dialysis for a patient. She says that doctors and policy makers need to assess whether they are adequately preparing patients and families to make fully informed decisions, and she advocates for a standardized approach for doctors to follow to help better guide patients and keep them at the center of medical decisions involving their care.

“With a decision like whether or not to start a medical treatment like dialysis, we, as physicians, need to make sure patients and families fully understand all risks and benefits and that patients’ voices are heard,” says Dr. Chretien. “We also have to be better about accepting a patient’s decision not to pursue the aggressive route and not let our own biases, or the “do everything” mentality of our health care system, silence patients.”

The essay can be accessed at