Table 1 Conditions when the temporary decision to forgo dialysis should be considered

1. When there are difficulties in the safe performance of dialysis and the patient’s life is at risk

 (1) The patient is in a condition where dialysis is harmful rather than beneficial to life because of multiple organ failure causing circulatory and respiratory problems, sustained hypotension, or other problems that make sustaining life extremely difficult

 (2) The patient is in a condition where dialysis can be performed safely only with the use of physical restraint and sedation

2. When the patient’s general condition is extremely poor and his or her decision on the temporary decision to forgo dialysis is clearly expressed or when family members can infer the patient’s decision

 (1) The patient is in a condition where serious cerebral dysfunction due to sequelae of cerebrovascular disease, head injury, etc., prevent him or her from having the comprehension necessary to undergo dialysis and recuperation

 (2) The patient is in a condition where death is imminent because of an incurable malignant comorbidity, such as a malignant tumor

 (3) The patient is not capable of oral intake, and long-term life-sustaining artificial hydration and nutrition are expected