Reflections on Refusing Medical Care: Close Relationships can Give US Reasons to Care for Others, Even when the Care is a Burden. They can Also Give US Reasons to Accept Care--Even when Accepting Care Means Becoming a Burden (Being A Burden‪)‬

Knowing that one is a burden is often painful. For the chronically or terminally ill, knowing that one is a permanent and difficult burden can be excruciating. The suffering is sharpest when the person-offering the care, bearing the burden, is a loved one. There are reasons for this. Insofar as we care deeply for people, we want them to flourish, not to be diminished by the burdens we pose. Insofar as we respect individual autonomy, we want them to be flee from burdens that undermine their projects. We also seek to be equal partners in our close adult relationships, and generally to be on an equal tooting with the people around us, and being a burden makes equality difficult. Some philosophers have claimed that refusing expensive life-saving treatments and even altruistic suicide can be justified to avoid being a burden. (1) Others have even claimed that, in extreme situations, there is a duty to die. (2) But this is not merely a theoretical issue. Many of those who request physician-assisted suicide say that one of their main reasons for wanting to die is their desire not to be a burden to others. (3)