We should not play God

It was shortly before Christmas. Richard was 38 years old and had inoperable non-small cell lung cancer. Chemoradiotherapy had held the disease at bay for a while, but at the expense of his renal function. Two weeks earlier, he had been told that no further treatment was possible and to prepare for the worst. Dialysis was not an option, so there was no point in seeking a renal opinion. He had been discharged from the tertiary unit for palliative care.

The call came at 10 pm from the local chest physician. Richard was breathless, oligoanuric, and in …