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Byline: N. Zamperetti (1), C. Ronco (2), A. Brendolan (3), R. Bellomo (4), G. Canato (5), M. Irone (1), S. Barbacini (1), R. Carraro (1), G. La Greca (3), P. Piccinni (1), M. Dan (1) Keywords: Key words Bioethics; Continuous Renal Replacement Therapy (CRRT); Futility; Vital supports; Ethics committees Abstract: Objective: To examine the ethical approach of intensivists and nephrologists to continuous renal replacement therapy (CRRT).APDesign: A questionnaire.APSetting: The First International Course on Critical Care Nephrology.APParticipants: The participants in the course (around 500).APResults: Most participants think that establishing ethical criteria for managing CRRT is a medical task, as clinicians have adequate criteria for defining futility. However, many responders would grant the request of starting futile CRRT or would maintain it if requested by the family. Only 55 % believe that informed consent is necessary for initiating CRRT one out of four would start or maintain unwanted life-saving CRRT. In case of lack of equipment, the majority would select the patients, excluding the worst one or on a 'first-come, first-served' basis. Withholding and withdrawing are regarded differently by most responders. Again, most think that every vital support should be withdrawn when futile, but practical and psychological aspects still influence the final decision. Responders think that ethics critical care committees can help in the management of ethical problems in ICU.APConclusions: Our results show that several ethical questions are still unsolved and that practical and psychological aspects of the treatment process can be stronger than bioethical principles. Author Affiliation: (1) Department of Anesthesia and Intensive Care Medicine, St. Bortolo Hospital, Via Rodolfi 37, I-36100 Vicenza, Italy e-mail: ulss6005@goldnet.it Tel.: + 39--0444--993 508 (Dept.)/ 993 862 (ICU) Fax: + 39-04 44-99 39 77/92 75 67, IT (2) Renal Research Institute, New York, N. Y., USA, US (3) Department of Nephrology, St. Bortolo Hospital, Via Rodolfi 37, I-36100 Vicenza, Italy, IT (4) Department of Intensive Care, Austin & Repatriation Medical Center, Heidelberg, Victoria, Australia, AU (5) Department of Statistics, St. Bortolo Hospital, Via Rodolfi 37, I-36100 Vicenza, Italy, IT Article note: Received: 16 February 1999/Final revision received: 30 June 1999/Accepted: 23 November 1999