الفهرس 
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Abstract
Background: Treatment for end-stage kidney disease is a major economic challenge and a public health concern worldwide. Renal-replacement therapy poses several practical and ethical dilemmas of global relevance for patients, clinicians, and policy makers. Aim: The aim of the present work was to highlight ethical challenges encountered by health care professionals working at Artificial kidney units of Ain Shams University hospitals which may oppose their practice and lead to malpractice. In addition, outlining an ethical guide; in a trial to metigate some of these challenges, and ameliorate the practical environment to minimise malpractice issues. Method: The present study is a descriptive cross-sectional study that was held on health care professionals (physicians and nurses) working at the Artificial Kidney Units of (El Demerdash and Ain Shams specialized University hospitals). Results: More than half of the physicians (57.9%) agreed that all patients admitted to kidney units should sign a legal informed consent, while 78.9% of physicians admitted that not all patients could give a legal informed consent. Nearly all physicians (94.7%) endorsed that the clinician should provide the patient with all needed information; then, the patient decides freely based on his priorities and values. 57.9% of the physicians and 48.3% of the nurses negated any discussion about patients’ private information within the earshot of others. The vast majority of physicians (92.1%) and nurses (83.9%) were completely convinced of the right of any patient -in need- to have an equal access to any form of treatment. Most of the physicians (71.5%) and 90.3% of nurses were convinced that beneficence and non-maleficence are not two opposing ethical concepts. Conclusions: The current study clarified that significant proportion of physicians and nurses were aware of the universally recognized ethical principles which are essential part of clinical practice in nephrology. The present study found that some healthcare professionals reported encountering a number of ethical issues when dealing with patients. Recommendations: The growing public and professional discourse about ethical issues in nephrology creates an atmosphere in which the special issues in End Stage Renal Disease treatment can be addressed openly. As some healthcare providers in this study reported some ethical issues when dealing with hemodialysis patients, thus, there is a need for ongoing education of ethics to ensure the optimal approach to patient care. It is recommended to follow our guideline proposal in order to help health care professionals in dealing with the confronted ethical challenges.