ABSTRACT
In this chapter, the authors focus on how the pioneering Seattle Artificial Kidney Center has tried to respond to the questions. They delegate on the board of trustees is given an annual "dollar goal" to cover the treatment costs of old and new patients living in the territory it covers. The authors examine the history and workings of the center's patient selection committee in greater detail, they see why it soon became a subject of national attention as it executed its arduous task of allocating a scarce new medical resource among persons who would soon die without it. In 1960 long-term hemodialysis became possible, making feasible the continuing treatment of patients with chronic, irreversible kidney failure. The advent of chronic hemodialysis as an alternative or adjunct to the then fledgling procedure of renal transplantation created a penumbra of complex and often painful issues.
