Ethical Issues in Dialysis Aaron Spital, Series Editor: Quality End‐of‐Life Care in Dialysis Units
Bibliographic record
Abstract
Quality end-of-life care has not been a priority in dialysis units and patients often experience prolonged dying while suffering needlessly. Advance directives (ADs) and decisions to stop dialysis have been highlighted by the medical profession as priorities in improving the quality of care, yet these are only two aspects of end-of-life care. They may not reflect patients' priorities and may not have the expected impact in improving the quality of end-of-life care. This review argues that quality end-of-life care should be a clinical priority in the care of dialysis patients; end-of-life care needs to be developed primarily from the patients' perspective; a clinical framework is required that integrates many aspects of end-of-life care; and end-of-life care should be initiated much earlier in the course of patients' illnesses than traditionally is done. By communicating more effectively and sooner with patients, their values and needs can be identified so we will be better able to plan and facilitate their end-of-life care and improve their experience of dying.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.033 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.012 | 0.015 |
| Insufficient payload (model declined to judge) | 0.003 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".