Family Centered Decision Making in Advanced Chronic Kidney Disease. From individual autonomy to family or community autonomy


  • Laura Margarita Forero Pontificia Universidad Javeriana
  • Martha Patricia Rodríguez Sánchez Pontificia Universidad Javeriana
  • Efraín Méndez Castillo Pontificia Universidad Javeriana
  • Ana María Medina Ch. Pontificia Universidad Javeriana


The increase in the incidence and prevalence rate of Chronic Kidney Disease poses challenges and ethical dilemmas that patients, family members and health professionals must face daily. The objective of this article is to present a reflection on the way in which patients make recourse to third parties as participants in their decision-making, which would require an approach based on solidarity autonomy. The analysis of twelve semi-structured interviews conducted with patients 60 years of age and older, from different programs of the Nephrology Unit of the Hospital Universitario San Ignacio in the period 2017-2018 Colombia, is presented. This article proposes the need for family-centered decision making of patients with chronic diseases, before their state is advanced and states of unconsciousness prevent their self-determination, considering the social determination of autonomy.


renal insufficiency chronic, personal autonomy, decision making, ethics, clinic, qualitative research