Thailand’s dialysis policy reform, introduced in 2022, aimed to enable universal access to life-sustaining dialysis, but instead exposed systemic vulnerabilities that undermined dialysis quality, compromised patient safety and threatened sustainability of care. These outcomes highlight three ethical dilemmas — access versus quality, continuity of care, and financial conflicts of interest — and offer powerful insights into the ethical tensions that are shaping kidney care globally.

Read full article: When access outpaces ethics: reflections on dialysis expansion and health system integrity | Nature Reviews Nephrology