American journal of kidney diseases : the official journal of the National Kidney Foundation
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Ethical and legal issues affecting geriatric nephrology are conditioned more by individuals' status as elderly, sick people than by the distinctive characteristics of kidney disease or failure. Key ethical issues are the obligation to respect persons, in particular by recognizing competent persons' autonomy of medical choice and affording due protection to dependent or vulnerable individuals, by beneficence or doing good, and by acting with justice, treating like cases alike and avoiding unjust discrimination. The law reinforces ethical obligations through such legal concepts as informed consent and the duty to maintain appropriate confidentiality, which have special applications concerning medication and management of the elderly. Additional legal issues concern advanced care directives and terminal care decisions.