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Comment & Response
June 2019

“Not Shared” Need Not Mean “Not Patient Centered”: Deciding That a Patient Is Not a Candidate

Author Affiliations
  • 1Stanford University School of Medicine, Stanford, California
  • 2Stanford Center for Biomedical Ethics, Stanford, California
JAMA Intern Med. 2019;179(6):851-852. doi:10.1001/jamainternmed.2019.1227

To the Editor In their Original Investigation published in a recent issue of JAMA Internal Medicine, Wong and colleagues1 reported that decisions to forgo maintenance dialysis for patients with advanced kidney disease were sometimes based on a physician’s view that the patient was not a candidate for dialysis. Although the study concludes by noting that such decisions often omit consideration of the patient’s values and goals, this conclusion sidesteps an important aspect of medical decision making.

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