| Round 1 Hospital 1/Ethicist 1/(27) | ♂, age 67 years, several diseases and complications affecting quality of life; suffering connected with continued dialysis | “An already complicated question was proved to be even more difficult. What I reflect mainly over is the lack of discussions between professional groups.” |
| Round 2 Hospital 1/Ethicist 2/(15) | ♀, age 41 years, dialysis since age 16 years, late complications, psychosocial problems; non-compliance with medical regimen | “We must dare to confront the patient. Ask: What do you want out of life? Stand up for your professional integrity and responsibility, and be clear with the patient about what my professional ethics are.” |
| Round 3 Hospital 1/Ethicist 3/(14) | ♂, age 55 years, non-Swedish-speaking, suicidal, confused, has deportation order; suffering | “It makes a difference who owns the problem, where I should put the focus, what I can do myself and what my own ethical problem is. Don’t expend energy on what is beyond your own problem.” |
| Round 4 Hospital 1/Ethicist 1/(11) | ♂, age 63 years, non-Swedish speaking, investigated for kidney transplant, cooperation difficult; non-compliance with medical regimen | “How important communication is and that we must try to find out what the patient actually understands. To get to know the patient better. The philosopher dared to formulate words we had thought but not said.” |
| Round 5 Hospital 2/Ethicist 2/(19) | ♂, age 61 years, deceased, rotted away; gangrene in extremities and genitals; suffering connected with continued dialysis | “The importance of sitting down all of us together to discuss treatment and get answers from the physicians about their view on the care of the patient.” |
| Round 6 Hospital 2/Ethicist 1/(11) | ♀, age 89 years, deceased, pain, anxiety, confusion; suffering connected with continued dialysis | “Neither we nor anyone else could do anything. Moral stress is a good explanation for how we all felt. It is difficult to prevent it from happening again.” |
| Round 7 Hospital 2/Ethicist 2/(7) | ♂, age 71 years, feebleness; distress over patient’s decision to discontinue dialysis | “The thoughts I got are that the patient’s points of view on what is right or wrong are the ones that must be followed. The only way I can find is to ask. Then I always need to ask myself how my own part influences the decision.” |
| Round 8 Hospital 2/Ethicist 4/(14) | ♂, age 61 years, deceased, not informed about malignant disease; truth-telling about bad news | “That everybody is responsible. It is too easy to blame and put the responsibility on somebody else. Information is incredibly important but sometimes difficult to give.” |
| Round 9 Hospital 3/Ethicist 4/(26) | ♂, age 62 years, expresses a desire to die, aggressive, cooperation difficult; non-compliance with dialysis regimen | “We analysed several ethical dilemmas. I experience even more strongly what an enormous human tragedy it is. I understand the importance of close collaboration regarding this patient. We must go to the bottom of his wish to die.” |
| Round 10 Hospital 3/Ethicist 1/(14) | ♂, age 61 years, skips dialysis, sometimes wants to discontinue it, does not appreciate information; non-compliance with dialysis regimen | “In some way this person must be helped to gain awareness of his illness. The staff as a whole must also set joint boundaries.” |
| Round 11 Hospital 3/Ethicist 4/(16) | ♀, age 88 years, deceased, feebleness; family wanted dialysis to be continued, suffering connected with continued dialysis | “Important to be involved in the decision-making process. To dare stand up for your convictions and listen to others. If you understand why, it is easier to comply and reach a decision. The information to family and patients is super-important.” |
| Round 12 Hospital 3/Ethicist 2/(20) | ♂, age 62 years, skips dialysis, refuses admission to hospital, cooperation difficult; non-compliance with medical regimen | “I see why care planning is necessary. I see that it is incredibly difficult with this patient, thought that the problem could be solved, but realise that it is extremely difficult.” |