What Scribner Wrought: How the Invention of Modern Dialysis Shaped Health Law and Policy

In March 1960, Clyde Shields, a machinist dying from incurable kidney disease, was connected to an "artificial kidney" by means of a Ushaped Teflon tube that came to be known as the Scribner shunt. By facilitating long-term dialysis, Dr. Belding Scriber's invention changed chronic kidney failure from a fatal illness to a treatable condition. A half-century after this milestone, there are now more than 1.6 million people throughout the world on maintenance dialysis. This medical advancement has, in turn, had a profound impact on key areas of health law and policy.

This paper focuses on the historical roots and current context of three interrelated areas: ethical allocation of scarce medical resources; public financing of expensive health care; and decisions to stop treatment for non-medically indicated reasons.