A social work perspective on ethical practice in end-stage renal disease.

Social workers increasingly are defining problems that they encounter in practice in health settings as ethical dilemmas. A distinction is made between those practice questions that can best be answered by an appeal to theoretical or empirical knowledge and expertise (clinical questions) and those which invoke values and ethical imperatives (ethical questions). End-stage renal disease poses in high relief the practice dilemmas that are encountered by social workers and offers an opportunity to explore and clarify issues in resolving them. Using an exchange framework as a basis for analysis, common ethical problems of end-stage renal services are discussed.