Issue 155 Item 7 A Country Limits Diabetes Dialysis Treatment!

Could this be in store for the U.S. and other countries? With diabetes becoming an epidemic in the world, countries are having to make some difficult decisions to limit care, they are just running out of resources.

Talks will be held to decide whether a kidney patient from the Pacific Islands will be allowed to continue dialysis at Auckland Hospital – treatment he needs to survive.

The anonymous Tuvaluan man’s fight for life saving medical treatment is apparently the tip of the iceberg. Each year, hundreds of Pacific Islanders seek treatment and thousands of dollars in unpaid bills are left for the New Zealand tax-payer to pick up.

The Health Ministry offered up guidelines telling clinicians to give foreign renal failure patients two weeks to make alternative arrangements, then stop giving them dialysis. But some argue that may be illegal.

Professor David Seedhouse, specialist in Medical Ethics at Auckland University of Technology: “I think a line has to be drawn about who you treat when you have limited resources, but they have put it in the wrong place ethically and legally. Those policy guidelines need to be revised and need to be revised urgently.”

The government and public authorities are subject to the Bill of Rights Act and are not allowed to discriminate on the grounds of race or ethnicity.

But our dialysis service is already running at capacity and the Pacific Islands’ diabetes problem is expected to double in the next 20 years. The Tuvaluan patient receives dialysis three times a week.

One solution might be to treat health costs for Pacific Islanders separately.

In the case of the Tuvaluan man, his dialysis is due to end on Tuesday, although the 30 year old father of three is hoping his lawyer will win him a two year temporary permit, so he can be treated here as a New Zealander.

Costs about $70,000/yr to dialysis one patient… They spend about $600,000/yr on overseas patients, mostly pacific islanders…

The rate of diabetes among pacific island peoples is expected to double over the next 20 years. Renal dialysis unit at Auckland is running at capacity…