As they age, many people are afraid that they might become a burden to their families and friends. In fact, fear of being a burden is one of the most frequently cited reasons for individuals who request physician aid in dying. Why is this fear so prevalent, and what are the issues underlying this concern? I argue that perceptions of individual autonomy, dependency, and dignity all contribute to the fear of becoming a burden. However, this fear is misplaced; common conceptions of these values should be re-framed and re-examined. Practices that support a more community-centered type of autonomy can be found in dependency and dignity. This paper offers some practical examples of how to address common end-of-life situations that may cause anxiety to patients who are worried about being a burden. These practices include discussing expectations, both for care and how the relationship among the participants might change, and modeling respectful caregiving behaviors. Most difficult of all, though, includes cultural and societal attitude changes so that people recognize the good in receiving care and get used to the idea that they do not need to do anything to be valuable.

随着年龄的增长，许多人担心自己会成为家人和朋友的负担。事实上，害怕成为负担是个人在死亡时请求医生援助的最常见原因之一。为什么这种恐惧如此普遍，这种担忧背后的问题是什么？我认为，对个人自主、依赖和尊严的看法都会导致害怕成为负担。然而，这种恐惧是错误的。应该重新定义和重新审视这些价值观的共同概念。支持以社区为中心的自治类型的实践可以在依赖和尊严中找到。本文提供了一些实际示例，说明如何解决可能导致担心成为负担的患者焦虑的常见临终情况。这些做法包括讨论期望、护理以及参与者之间的关系可能如何变化，并塑造尊重的护理行为。然而，最困难的是文化和社会态度的改变，以便人们认识到接受护理的好处并习惯于他们不需要的想法做任何有价值的事情。