{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T14:04:06Z","timestamp":1785074646165,"version":"3.55.0"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Clinicians often face situations in which patients or families desire aggressive care that medical teams believe offers no meaningful benefit. Traditional shared decision-making frameworks may inadequately address these tensions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 53-year-old woman with metastatic lung cancer desired full resuscitation despite progressive multisystem organ failure. She identified as a \u201cfighter\u201d but faced a clinical dilemma: adequate pain control required accepting respiratory compromise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>We apply the bioethical construct of maternalism, integrating relational autonomy and informed non-dissent to support clinician-guided decision making that preserves patient values while unburdening families from impossible choices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Maternalism offers palliative care clinicians a theoretically grounded approach for navigating value-laden decisions when patients cannot or choose not to bear the weight of deciding.<\/jats:p>\n                  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