Bioethics in nephrology: Guidelines for decision-making in Italy

In 1998, the Italian Ministry of Health urged the Italian Society of Nephro logy (SIN) to draft recommendations for uniform decision-making procedures in the field of dialysis. In accordance with the Ministry's specifications, at the time the Society approved diagnostic protocols regarding clinical q uestions, but without fully recognizing the multiple issues arising in comp lex medical situations where dialysis is likely to go on for a long time. T he authors propose some guidelines for ethical conduct and their applicatio n, with special regard to medico-legal dilemmas, together with the principl es of clinical guidelines that would further improve the "perceived quality " of chronic dialytic treatment.