A recent news says that 20 patients with renal insufficiency who had required hemodialysis have refused to undergo that treatment at a public hospital in Tokyo for the past 5 years. It is of dispute whether the medical staff has given the right information as for the result of their decisions or not. And a patient who had decided not to take hemodialysis afterward wanted, as the news said, to restart the treatment. It did not come true and she has died in a day. Only little information has come out of the medical staff/hospital regarding this problem. The hospital affirmed that they had objectively explained the outcome of her decision. There seems to be an investigation being made as for this case.
Basically, I won't approve that any decision of the patient should be forced by medical staff or even law makers. I firmly believe that medical doctors should work as much as possible in order to save their patients' lives. It is a principle which should not be affected by anybody.
It is a reality, however, that the number of the patients with renal insufficiency is increasing as the aging is progressing in the society. It is nearly 360K at present. On the other hand, the hemodialysis apparatus is only 1/3 of the patients in number. It takes 4.5K US bucks per a patient per a year even despite of the modern progress of hemodialysis technology. With the increasing number of the patients, the medical staff might have much difficulty to do with them. The social security system, finance wise as well as man power wise, is challenged with the burden of more hemodialysis cases.
The mass media is in a tone criticizing the medical staff/hospital for the case above mentioned. It should be clarified by any third party investigators if there has been any problem regarding the process of decision making by the patients. Meaningless emotional criticism against the medical system could destroy it easily since it is carrying on its work without much reserve capacity.