The use of a palliative technique such as renal dialysis is cost-consuming in terms of budget, healthcare professionals, space and equipment. Contrary to the selective practice of the 1960s, the current practice is open to a greater number of people of whom a sizeable number are afflicted with co-morbidities. Such conditions give rise to many ethical issues connected to various stages in the care-giving process. In this article, these issues are studied by using both scientific writings from the past ten years and results of an exploratory study conducted at two Québec dialysis centers.