Improvement in prolongation and quality of life has been made possible by medical progress, but life for the patient can become ever more dependent on artificial support and death may be prolonged in unwanted ways. The choice between prolongation of life, quality of life and the abatement of suffering is of great importance in decisions on the continuation or cessation of dialysis and is naturally a process of weighing different positions. This process requires not only medical decision-making but also a structure for the organization of communication between all involved parties. Only thus is it possible to reach a satisfactory resolution to such a situation, a resolution that shows medical responsibility on the part of the physician and one that can be borne by all those involved.