I can’t take care of all my mom’s needs. Am I a monster?

Welcome to Your Mileage May Vary, my new twice-monthly advice column offering you a framework for thinking through your ethical dilemmas and philosophical questions.
Your Mileage May Vary isn’t like other advice columns, which usually aim to give you a single answer — the underlying premise being that there is an objectively “right” answer to the complex moral questions that life throws at us. I don’t buy that premise.
So I’m reimagining the genre. My advice column is based on value pluralism, the idea — developed by philosophers like Isaiah Berlin and Bernard Williams — that each person has multiple values that are equally valid but that sometimes conflict with each other. When values clash, dilemmas arise.
What happens when you value authenticity, for example, but also want to use ChatGPT to write your wedding speech because it would be more efficient? Or when you value fighting climate change but also desperately want to have kids?
When you write in with a dilemma, I won’t give you my answer; I’ll show you how to find your own. First, I’ll tease out the different values at stake in the question. Then I’ll show how wise people — from ancient philosophers to spiritual thinkers to modern scientists — have thought about these values and conflicts between them. Finally, I’ll guide you to decide which value you want to put more weight on. Only you can decide that; that’s why the column is called Your Mileage May Vary.
Here, I answer the first Vox reader’s question, which has been condensed and edited for clarity.
My mother is retired, disabled, and poor. I assist her with her medical care by arranging appointments, talking to her doctors, and finding medical resources that she needs for her many ailments. I’ve even been able to find a home health aide to come to her house six days a week to assist her with daily cleaning, cooking, and other tasks.
But as she ages, I know she will need more help than I can provide from afar. And I know I cannot take on the actual tasks of caring for an elderly person with the many issues she has. … Am I a monster for accepting the fact that she will likely end up in a state-run retirement community?
Dear Definitely-Not-a-Monster,
This is not a traditional advice column, where someone writes in with a question and comes away with a simple answer. In your case, though, there is one question I can answer very simply right off the bat: “Am I a monster?” The answer is no. The world isn’t divided into good people and bad people (despite what fairy tales and superhero movies tell us). We’re all just human beings, trying to live in line with our values as best we can under the conditions we’re given.
It’s clear that you hold multiple values simultaneously. You want your mother to be well-cared for. You also want yourself to be well-cared for.
What could be more natural? I imagine that every animal on Earth feels this dilemma in their guts. And, demographically, it’s a fact that more and more people are going to find themselves in exactly this position as baby boomers age. But I also know from personal experience that just realizing how common a dilemma is doesn’t make the internal tug-of-war any less confusing or painful.
People have been wrestling with this painful confusion for thousands of years. They’ve come up with different ways to navigate trade-offs between these competing values, depending on the social mores of the time. We can learn from the insights they’ve surfaced along the way.
Historically, even ancient traditions that take filial piety very seriously acknowledge that there will always be a tension between caring for your parents and caring for yourself. In Judaism, “Honor your father and your mother” is one of the Ten Commandments — it’s not all 10! In fact, biblical commentators have understood another commandment from Deuteronomy, “Guard yourself and guard your soul very carefully,” to mean that you’re obligated to take care of your own body and soul.
In the Chinese ethical tradition of Confucianism, your body is considered a gift from your parents, so to harm its health (for example, by stretching yourself too thin) would be to disrespect them. That means caring for your parents can’t be the be-all and end-all value without becoming self-defeating.
So to ask the question “What should care for my mom look like?” is to ask the question at the wrong level of granularity. A better question might be “What should care for my mom look like, considering everyone involved?”
To answer that, you’ll want to think about your mom’s evolving needs, but you’ll also want to consider: How much bandwidth do you have in terms of your physical and mental health? Who else is counting on you — a partner, a child, a dear friend? What other commitments do you value?
You straight-up say, “I know I cannot take on the actual tasks of caring for an elderly person with the many issues she has.” That actually makes things pretty simple in your case. Even Immanuel Kant — the 18th-century German philosopher I think of as Mr. Duty — said that “ought” implies “can,” meaning that if you’ve really thought through the situation and concluded that you can’t care for your mother on your own, you aren’t morally obliged to.
But there’s a more radical point to internalize here: Even if we imagine a scenario where you can take on all these tasks for your mom, that alone doesn’t mean you should. Being able to do something is necessary but not sufficient for having an obligation to do it. Even if, for example, you could have your mom move in with you, it doesn’t automatically follow that that’s a wise idea. It depends on what the effects would be on everyone involved — yourself included.
If you feel that the effects of doing something, even something “good,” are prohibitive, that’s not an indictment of your morality as an individual. Modern life does not make caregiving easy.
As the surgeon Atul Gawande explains in his book Being Mortal, children used to live close to their parents and parents used to, well, die earlier. It was more feasible for children to be their parents’ caregivers. Now, we live in a globalized world where the young often migrate to get an education or a job, and surviving into old age is much more common. (For someone born in 1900, the global average life expectancy was 32 years; now that we have more medical knowledge and less poverty, it’s 71 years, and substantially higher in high-income countries.)
Plus, today’s parents are having kids later in life than in the past, so when the parents reach old age, their offspring are in their prime. That means the young are trying to establish their careers and raise their own children at exactly the time their parents experience declining health and call for help — often from afar.
Our society is not set up to handle that. And it’s one of the reasons why retirement communities first became a widespread fixture of American life in the 1960s.
These communities vary a lot in quality. You can try to find one with qualities that appeal to your mom, but you might also have to accept the fact that her living conditions may not be ideal. She might have an unhappy time there. That’s a societal failure that you can’t single-handedly fix. If you happen to be in a position to improve the system — if you work in public policy, say — great! Consider pulling those levers. More likely, though, you’ll want to focus on what you can do for her right now, given the system you live in and given all your other commitments.
The existence of retirement communities doesn’t mean you should totally exempt yourself from caring for your mom. How you approach caregiving has implications for her, but it also has implications for your own moral development.
Philosopher Shannon Vallor argues that the experience of caregiving helps build our moral character, allowing us to cultivate virtues like empathy, patience, and understanding. So outsourcing that work wouldn’t just mean abdicating a duty to nurture others; it would also mean cheating ourselves out of a valuable opportunity to grow. Vallor calls that “moral deskilling.”
Yet she’s careful to note that caring for someone else doesn’t automatically make you into a better person. If you don’t have enough resources and support at your disposal, you can end up burned out, bitter, and possibly less empathetic than you were before.
As Vallor says, there’s a big difference between liberation from care and liberation to care. We don’t want the former, because caregiving can actually help us grow as moral beings. But we do want the latter, and if a retirement community gives us that by making caregiving more sustainable, that’s a win.