The magazine’s Ethicist columnist on weighing a sibling’s needs against your own — and more.
I am in my 60s and have been married for decades. One of my brothers is moderately schizophrenic; he does well on his medication but is increasingly unable to live alone. He and I are not close and are very different people, but when our mother went into a nursing home several years ago, he came to live with my wife and me. Several other siblings living close declined to take him in.
My brother can’t live alone for a number of reasons, including forgetting to take his meds and not being able to take care of himself or his living quarters. Otherwise, he is a good person, a brilliant artist (that was his career path) and tries hard to be considerate. Schizophrenia is a terrible thief of independence.
My wife and I are now retiring. We conscientiously put money away for retirement and to support our shared goal of traveling extensively. We have friends and family around the world with standing invitations for long visits.
In addition, my wife simply does not want to live with my brother during retirement. I admire her compassion for agreeing to take him in years ago, but he does require care and patience. Also, his moderately sexist attitudes have led to a number of conflicts over time. I cannot fault my wife for wanting and expecting to continue with our plans, especially with the Covid shutdown now (hopefully) lifting, but I am completely torn.
We must find some other arrangement for my brother. My wife speaks relatively lightly of putting him in assisted living. Doing so will decrease his quality of life drastically. Our income has allowed us to help him extensively with everything from dentures to art supplies. He has little except his monthly Social Security check.
Ethically, how responsible am I for my brother? How do I justify making arrangements for him to go into assisted living so I can enjoy the retirement we planned on, knowing that his quality of life will diminish? How do I set aside this strong sense of disappointment in myself? Name Withheld
There are three kinds of demands in play here, which reflect the pull of three kinds of “partiality.” (That’s the word philosophers have come to use for the special concern we properly have for certain people by virtue of our connections with them.) There is your special concern, as a thoughtful sibling, for your brother. There is your special concern, as a loving spouse, for your wife. And then there’s your special concern for your own projects, such as travel, because human beings are partial to — and entitled to be partial to — themselves. It’s a mistake to think that giving special weight to your own interests and concerns is egoism; egoism is giving them more weight than they merit. You have a legitimate interest in living a well-lived life; you’re not obliged to devote yourself totally to the well-being of others. It’s worth bearing in mind that ethics, as Aristotle originally conceived it, was precisely an inquiry into what it meant to live well.
And as you recognize, the decisions you face are not yours alone. Your wife has already been putting up with the strain of living with a difficult housemate, who, it seems clear, doesn’t always treat her with the respect she is due. (We can debate how much to hold your brother responsible for his attitudes and behavior, but she can avoid taking offense only by treating him as a patient and not as a person.) Further, it would seem that she’s asking you to recognize your own right to the extensive plans you shared as well as hers. If you refused to give your and your wife’s interests their proper weight, you’d have greater reason to be disappointed in yourself.
Notice that you’re contrasting the life he has now with the disadvantages of life in assisted housing. To weigh that comparison, you need a realistic sense of what life will be like for the foreseeable future in both cases. Might you be exaggerating the quality of life he would enjoy if he continued staying with you? If you and your wife are forced to jettison your retirement plans, you’d have to be saints not to resent it. Although you’re not close to this brother, part of the benefit to him of living with you must come from the relationship that you have; his awareness of his hosts’ resentment, accordingly, would probably diminish the quality of his life.
It’s a mistake to think that giving special weight to your own interests and concerns is egoism; egoism is giving them more weight than they merit.
If his staying with you could be worse than you imagine, life in assisted living might be better. Of course, it will be a difficult transition, but you can put some of your moral energy into securing an assisted-living situation that’s as good as you can find. Only when you have actual options to consider can you assess what sort of quality of life he can have outside your direct care. And you should certainly try to involve him in thinking about these options. (It would be wise to discuss all the options with a psychiatrist or social worker who understands the specifics of your brother’s diagnosis.)
Let me remind you too that the responsibilities you have to him are shared with other family members. If they won’t do their part, you’re not obliged to take up their moral slack. But you can at least ask them for help in covering the costs of getting him a decent living situation. You can also spend time with him when you aren’t on the road and urge your other siblings to do the same.
A final point. As with your mother, you may eventually be incapable of independent existence: making the transition with care now may be better for all involved than making sudden big changes later, amid whatever frailties age may bring you. Of course, even if you recognize that your feelings of self-reproach are unwarranted, they will not thereby be entirely dispelled. That there are no costless choices here, though, reflects the usual human condition. You may find yourself concurring with an avowal of the poet and essayist Joseph Brodsky: “Life — the way it really is — is a battle not between Bad and Good, but between Bad and Worse.”
I am struggling as a first-time (vaccinated) parent with sending my child to day care. As you know, the C.D.C. says that children under 2 do not need to wear masks, and he’ll be in proximity to day care providers every day.
I recently asked the owner of the day care if she had a policy about vaccinations for her employees or if she was willing to offer an update on their vaccination status. She told me that the state never even required flu vaccines and that she did not think it was likely they would require this one. The day care is not state-owned; it’s private. Doesn’t she have the right to require her employees to get vaccinated? When I inquired further about the current employees, she said it would be a HIPAA violation to answer my question. Is there a right way to ask how safe this day care’s population is? Catherine Etter
As every parent knows, when infants travel back and forth between day care and home, they can carry infections with them in both directions. And an infection that isn’t serious in a child can be, as with Covid-19, very serious in an adult. (Of course, we don’t yet have a clear picture of how serious new variants will be for children.) The day care owner can and should require that her employees get vaccinated for Covid, allowing, naturally, for the religious or medical exemptions provided by law. Her hedging response to your question makes it sound as if she has no plans to do so. Still, you can ask her directly. Although HIPAA provisions are restricted to health care providers, insurers and the like, employers should not disclose personal health information about specific individual employees. But she can certainly tell you what the day care’s policy is. I confess that I’d have misgivings about putting my child in the hands of people who don’t see the value of vaccination in preventing the transmission of disease.
And by the way, we’ve been too inattentive when it comes to the shifting perma-epidemic of seasonal flu strains. In a typical year, the flu causes several tens of thousands of deaths in the United States; direct medical costs are estimated to exceed $10 billion and indirect economic costs are thought to be even greater. More widespread vaccination would reduce that death toll substantially. (So would better-targeted vaccine formulations.) The fact that we’re used to all this death and illness from the flu doesn’t mean we can’t do better.
Kwame Anthony Appiah teaches philosophy at N.Y.U. His books include ‘‘Cosmopolitanism,’’ ‘‘The Honor Code’’ and ‘‘The Lies That Bind: Rethinking Identity.’’ To submit a query: Send an email to ethicist@nytimes.com; or send mail to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, N.Y. 10018. (Include a daytime phone number.)
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