The bioethics of therapeutic obstinacy in the use of hemodialysis in patients with invasive cervical cancer during acute-on-chronic renal failure

Abstract

This article draws on elements from bioethics to discuss the indication of hemodialysis in women with advanced cervical cancer presenting obstructive renal failure and treated at a cancer hospital. The study considers patients both with previous radiotherapy and without any type of treatment due to the advanced stage of their disease. The question is whether the patients benefited from hemodialysis (as a substitute for renal filtration) in the control of uremia caused by compression due to tumor progression. The conclusion is that hemodialysis constitutes a form of therapeutic obstinacy in the advanced stage of the disease, with no anti-tumor benefit or improvement in the patient's quality of life. The authors' aim is to encourage the discussion of the concept of futile treatment. Inclusion of the moral aspects involved in medical treatment and studied by bioethics is viewed as a way of analyzing the multi-factor impact of the disease and its treatment on patients' quality of life.