{ "schema_version": "uw.editorial_geo.v1", "article_index": "AGE-133", "catalog_id": "AGE-133", "language": "en", "headline": "Burdensome treatment and personal goals: participating in the discussion", "description": "Connecting burdensome treatment discussions with personal aims, risks, supported participation and actual conditions without choosing a therapy for the reader.", "master_filename": "ARTICLE_EN.md", "master_revision": "staging-r1-20261019", "master_sha256": "50de8c53532912b207580dcbf07a2278a4a68af9bb3665719ffa00ee0fc378b4", "short_answer": "Clarify the decision, expected clinical result, personal priorities, possible burdens and implementation conditions. A person can request an understandable recommendation and support without becoming their own physician or granting all authority to family. Uncertainty proves no futility and establishes no safe delay: clarify urgency professionally. This article chooses no treatment or start, pause, change or refusal. Do not independently alter prescriptions, test endurance or remove food, care or relief for agreement. Current urgent help does not await a family dispute.", "claims": [ { "id": "C01", "type": "author_proposal_clarification", "text": "Meeting purpose, preliminary proposal, administrative action and the person’s agreement need distinction.", "source_ids": [ "T1" ], "article_sections": [ "I. Clarify which decision is being discussed" ], "limitations": "Fictional Oleg/Irina and cancer, no clinicalcase/consentform/actual method choice or universalclassification." }, { "id": "C02", "type": "bounded_professional_principle_and_author_reasoning", "text": "Personal aims and clinically possible outcomes are considered together while retaining different roles.", "source_ids": [ "T2" ], "article_sections": [ "II. Personal goals and medical outcomes are connected but distinct" ], "limitations": "GMCUKremit, no alloptionsguarantee/right to anyintervention/external life-value verdict; qualityoflife not familyjudgement." }, { "id": "C03", "type": "author_clinical_discussion_boundaries", "text": "Discuss benefits, burdens, risks, uncertainty and urgency with a competent team for the specific proposal.", "source_ids": [ "T1", "T2" ], "article_sections": [ "III. Name burdens without turning them into a verdict", "IV. Uncertainty and urgency need different questions" ], "limitations": "No percentages/drugs/doses/complication signs/homescale/safepause/refusal; secondopinion/access not guaranteed, no endurance or carewithdrawaltest." }, { "id": "C04", "type": "author_supported_participation", "text": "Support, accessible formats and asking about a recommendation can enable participation without independent research appraisal.", "source_ids": [ "T1", "T2" ], "article_sections": [ "V. Support makes participation more accessible" ], "limitations": "No household capacitytest/educationexam/allauthoritytransfer; nodding/calm/silence alone not understanding or freelygiven agreement." }, { "id": "C05", "type": "author_family_and_conditions_reasoning", "text": "Family roles, helper limits, needs and actually secured conditions differ; care is no reward for a convenient answer.", "source_ids": [ "T2" ], "article_sections": [ "VI. Family participation is not voting for the person", "VII. Actual conditions remain a separate task", "IX. Choice is not a final test of courage" ], "limitations": "No allaccess/absolute secrecy/majoritygoals/endlessduty/pressure/covertuse/selfprescriptionchange or food/care/reliefdenial; currenturgenthelp not delayed by dispute." }, { "id": "C06", "type": "author_ethical_comparison", "text": "AristotleIII.3 and AnalectsII.15 are compared through understanding action while preserving different grounds and critical limits.", "source_ids": [ "T3", "T4" ], "article_sections": [ "VIII. Deliberation and knowledge: Aristotle and a Confucian text" ], "limitations": "No clinicalproof/form, ancientassumedends not ban on patientpriorities; learning/diagnosis/disagreement not dignitytest or medicalopinion equality." } ], "questions": [ { "question": "Does treatment burden mean it should be refused?", "answer": "The article makes no such choice. Discuss burdens and risks with expected outcomes, priorities and actual conditions through a competent team; no intervention is selected here.", "claim_ids": [ "C02", "C03" ], "article_sections": [ "II. Personal goals and medical outcomes are connected but distinct", "III. Name burdens without turning them into a verdict" ] }, { "question": "Must a person appraise research independently?", "answer": "No such duty is imposed. Ask for an explained recommendation and suitable support while retaining participation and the professional’s clinical role. Help grants no universal authority.", "claim_ids": [ "C04" ], "article_sections": [ "V. Support makes participation more accessible" ] }, { "question": "Can a decision wait because there is uncertainty?", "answer": "This article prescribes no safe pause. Clarify urgency and delay consequences professionally for the circumstances; current urgent help does not await family discussion.", "claim_ids": [ "C03", "C05" ], "article_sections": [ "IV. Uncertainty and urgency need different questions", "VII. Actual conditions remain a separate task" ] } ], "sources": [ { "id": "T1", "title": "National Cancer Institute — Questions to Ask Your Doctor about Treatment", "url": "https://www.cancer.gov/about-cancer/treatment/questions", "edition": "Updated2023-02-22", "read_scope": "Fullmain17–56/version58/reusenote59 read; iStockphoto/linkedclinicalguides/studies not used", "role": "Cancer-specific questions inform original discussion of expectedresults/burdens/risks/practicalconditions/contact; no copied checklist, actual treatment choice, dosing, delay or guaranteed second opinion", "rights_status": "NCI_TEXT_REUSE_POLICY_CHECKED_WITH_ATTRIBUTION_AND_NO_ENDORSEMENT", "read_date": "2026-10-19", "search_executor": "Codex web.run / branch F author", "rights_notes": "Minimal attributed quotes/original paraphrase, ownRU/THhistoricaltranslations. NCIpolicy checked with exactnonendorsement allmasters, no wholetool/form/image/logo/PDQ; RESEARCH.md" }, { "id": "T1R", "title": "NCI — Reuse of NCI Information", "url": "https://www.cancer.gov/policies/copyright-reuse", "edition": "Reviewed2025-03-12", "read_scope": "Actual complete policy12–43/version45 read same sessionAGE-132, exactscope reused, not newly reread", "role": "Attribution/originaltitlelink, adaptedinformationlabel and exact nonendorsement statement all3masters; no graphics/logo/PDQ/fullNCIproduct", "rights_status": "POLICY_READ_NOT_GENERAL_GLOBAL_RIGHTS_FINDING", "read_date": "2026-10-19", "search_executor": "Codex web.run / branch F author", "rights_notes": "Minimal attributed quotes/original paraphrase, ownRU/THhistoricaltranslations. NCIpolicy checked with exactnonendorsement allmasters, no wholetool/form/image/logo/PDQ; RESEARCH.md" }, { "id": "T2", "title": "GMC — Working with the principles and decision-making models, part1", "url": "https://www.gmc-uk.org/professional-standards/the-professional-standards/treatment-and-care-towards-the-end-of-life/working-with-the-principles-and-decision-making-models", "edition": "Parent effective2010-07-01,updates2022-03-15/2024-12-13;2026update not established", "read_scope": "Actual AGE-132 displayed17–49/embeddedcontext read. Selected133:28–30complete115–122,40–42complete177–186,44–46complete219–228. Parent/Aboutscope and dates actually checked132, not wholeguide/linkedforms", "role": "Goals/benefitsburdensrisks/understandableterms/uncertainty/personalpriorities/support/avoidage-disabilitybias, UKprofessionalremit not homealgorithm/worldwidelaw/proxycapacitywithdrawalfeedingCPR decisions", "rights_status": "UNKNOWN", "read_date": "2026-10-19", "search_executor": "Codex web.run / branch F author", "rights_notes": "Minimal attributed quotes/original paraphrase, ownRU/THhistoricaltranslations. NCIpolicy checked with exactnonendorsement allmasters, no wholetool/form/image/logo/PDQ; RESEARCH.md" }, { "id": "T3", "title": "Aristotle — Nicomachean Ethics III.3, W. D. Ross", "url": "https://classics.mit.edu/Aristotle/nicomachaen.3.iii.html", "edition": "Exactprint/digitalupdatedate unknown; actualheader18–24 namesRoss", "read_scope": "CompleteIII.3lines65–80 read with displayedIII.1–2/4–5, not wholeBookIII/work or Greek", "role": "Ends/means/deliberation/help critically bounded; assumed professionalend not ban on discussing patientgoals, historicalrationality/compulsion/blame not modern capacity/consent/patientfault", "rights_status": "GLOBAL_AND_DIGITAL_EDITION_STATUS_NOT_ASSESSED", "read_date": "2026-10-19", "search_executor": "Codex web.run / branch F author", "rights_notes": "Minimal attributed quotes/original paraphrase, ownRU/THhistoricaltranslations. NCIpolicy checked with exactnonendorsement allmasters, no wholetool/form/image/logo/PDQ; RESEARCH.md" }, { "id": "T4", "title": "Confucius — Analects II.15, James Legge", "url": "https://www.gutenberg.org/cache/epub/3330/pg3330.html", "edition": "Gutenberg3330 release2002-07-01/update2021-01-08;exactprintbasis unknown", "read_scope": "Header0–31 and wholeBookII1–24lines50–82 read,mainII.15bothclauses71; not wholeAnalects/Chinese/notes/prolegomena, duplicateXVIIinfile not renumbered", "role": "Learning/reflection comparison not educationtest/medicalopinionequality, filialallauthority, patientblame or ban on further professional explanation", "rights_status": "GUTENBERG_TERMS_NOT_GLOBAL_RIGHTS_FINDING", "read_date": "2026-10-19", "search_executor": "Codex web.run / branch F author", "rights_notes": "Minimal attributed quotes/original paraphrase, ownRU/THhistoricaltranslations. NCIpolicy checked with exactnonendorsement allmasters, no wholetool/form/image/logo/PDQ; RESEARCH.md" } ], "retrieval_limits": [ "Fictional cancer scene, no actualdrug/treatmentchoice/prognosis/clinicaltrialreview/validateddecisionaid.", "No treatment initiation/refusal/pause/change/independentdose-combination/covertuse/homecomplication or urgency signs.", "Uncertainty proves no futility or safe waiting; clarify urgency professionally.", "Age/diagnosis/disagreement/silence/kinship/payment confer no universal authority; no household capacitytest/education or courage examination.", "No food/care/treatment/relief removal for proof, conversation, endurance or agreement; current urgent help does not await family/administrative dispute.", "GMCUKprofessionalprinciples are no worldwide law/familyalgorithm/forms/capacityassessment/withdrawalfeedingCPRprocedure.", "No alloptions/secondopinion/nightservice/freeaccess/mediator/absolute secrecy/endlesshelperduty; wish/plan/receivedhelp differ.", "Aristotle/Confucius provide no clinicalproof/consentform/banonpatientgoals/medicalequalityofopinions or education-diagnosis exclusion.", "NCIadaptedinformation with originaltitlelink/attribution/exactnonendorsement statement all3masters, no graphics/logo/PDQ." ], "schema_org": { "@context": "https://schema.org", "@type": "Article", "identifier": "UW:AGE-133:en", "headline": "Burdensome treatment and personal goals: participating in the discussion", "inLanguage": "en", "author": [ { "@type": "Person", "name": "Andrey Zarinsh" }, { "@type": "Person", "name": "Maria Evilkut" } ] }, "production_acceptance": "NOT_RUN", "production_machine_publisher_compatibility": "NOT_RUN" }