I strongly suspect that my husband is developing dementia. His doctors have found nothing wrong with him. I understand that ‘‘mini’’ cognition tests might not find anything amiss in the early stages of disease, and I imagine that what are now subtle changes will eventually become obvious. In the meantime, our decades-long relationship has eroded. My insistence that he engage with me in maintaining a quality relationship has led to endless fighting and brought me to the brink of divorce.
Since I’ve come to understand that early-stage dementia is at the root of our problems, I’ve quit trying to ‘‘fix’’ our relationship. Our fighting has stopped, but it’s a lonely place to be. I’m not thrilled about spending my retirement years as a caregiver. It’s a huge sacrifice that will narrow my own life significantly. Do we both need to go down with the ship? Can I leave now (and let his family deal with this)? Or am I obligated to stay and care for him? — Name Withheld
From the Ethicist:
The traditional Christian marriage vow was to stay together ‘‘in sickness and in health.’’ The possibility of divorce shifts the meaning of that promise — it becomes more of an ethical commitment than a contractual obligation. In a loving relationship, you support your spouse through hard times, including illness and decline, because you can’t easily imagine doing otherwise. The shared experiences and memories of a life together enable you to find warmth amid cold spells. Though every case is different, age-related dementia can erode people’s capacities without effacing the essence of their personality and character.
You talk about how your husband has changed; it’s also possible that you’ve changed. If medical professionals haven’t diagnosed dementia, it’s worth considering that your personal assessment could be mistaken. Either way, it sounds as if your worry isn’t so much that you’ll become a caregiver as that you won’t have a loving relationship with the person you would be caring for. Before you sever ties, though, I would encourage you to explore couples counseling attuned to the challenges of dementia. See if you can cultivate your own well-being while finding activities that play to your husband’s strengths. You should be able to grieve what is being lost and acknowledge whatever moments of resentment you feel without shame.
I’m not saying that you’re required to sacrifice your well-being to his. The special obligations we have to our loved ones are rooted in the value we place on our relationships with them, with all the resilience, and fragility, of those relationships. Still, I hope you’ll figure out a way to balance your needs with your husband’s. That doesn’t mean going down with the ship; it means trying to find a way to keep the ship afloat.
Readers Respond
The previous question was from a reader with a dilemma about her son’s ex. She wrote: “I’ve always supported a woman’s right to choose, not least because legal access to abortion once saved me from an untenable situation. I also believe that if a woman chooses to abort, her wish should supersede any opposition to it by the father. The physical, practical and emotional effects on a woman obliged to carry a child to term (and to care for it afterward) are, in my view, far more significant than they are for the father. But what about the reverse? What about a case in which the father (in this case, my son) is adamantly opposed to having a child, but the woman (his ex-girlfriend) wants to keep the pregnancy? While it’s not relevant to the moral question, the pregnancy is shockingly unexpected given a medical issue of the father’s. … Is it right to force someone to be a parent, even if in name only? … While it’s evident that he will have financial obligations, what might his moral responsibility be?”
In his response, the Ethicist noted: “Paternity has financial consequences. The law will expect a noncustodial parent to pay some amount of child support. But it can have other consequences too. Among the moral intricacies of abortion is that a mother who is forced to carry a pregnancy to term will, in the usual course of things, cherish the child that results. She can coherently wish that she had been allowed to terminate the pregnancy without wishing that this particular child did not exist. In this way, your son may feel that the child should not be born and that if the child is born, he should play a role in its life. His ex would have effectively imposed on him not just legal paternity but actual parenting. So yes, it may be unfair to encumber your son with the legal entailments — and perhaps the emotional ones — of paternity. But none of this deprives the woman of the right to do so.” (Reread the full question and answer here.)
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The letter writer’s son made his decision when he chose to have sex without making sure adequate birth control measures were in place. In essence, every man needs to understand that having penetrative sex with a woman comes with a nonzero chance of conceiving a child. Every time and whether he wants one, or not. Once he makes that decision, the rest is the woman’s choice. Maybe if more men understood this they’d be fighting harder for a woman’s right to reproductive freedom. — Jennifer
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When a man chooses to have sex with a woman, he is also choosing to give that woman the right to bear his child (or not), should she become pregnant. The decision of whether to bring the pregnancy to term is at her sole discretion. This is what it means for women to have the right to choose. This right holds whether or not steps were taken to reduce the risk of pregnancy. Suggesting that this decision could be “unfair” to the man is offensive. He had a right to choose not to have sex; that is not the choice he made. It is now fair that she has the right to make this decision absent the shaming and judgment that society has long and unfairly placed on women with unplanned pregnancies. — Joseph
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The Ethicist has it right. But doesn’t it feel harsh that the environment that we have created in our liberal world allows no room for the consideration of the putative father? Don’t want the child? Too bad. Pay for it anyway! And the fact is, some of these people concerned about fairness and obligation to these dads happen to be women — sisters and moms of the guys. (Too bad, ladies!) I would opine, however, that other than the financial obligation the law may impose upon him, a man who is forced to be a father has no ethical duty to be a dad. Genes are nothing but nucleotides. So, ladies, have it your way. We’re your partners, or we aren’t. That’s what choice is all about. And if we aren’t partners, every paternity dollar you take will cost your soul. — Steve
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I have personal experience with the dilemma the son is facing. When I was 19, a 24-year-old woman who already had a child came to me in the night and woke me up with her hands. At the time I was working with her brother and staying in their house. I responded as a 19-year-old would, and quickly she was gone. During a second and last encounter, I had enough wits about me to ask about birth control. She said, “You don’t know what it’s all about.” We parted company soon after, and nine months later she wrote a letter telling me I had a daughter. This led to decades of a fraught relationship. When the girl was 13, and I ascertained that she really was mine, I did my best to provide school funding and an allowance. I wince when I think of my parenting. I was young, had limited resources and was not a willing father. Even accounting for extenuating circumstances, I made a terrible hash of it. From this far distance, I can say that your obligation to parent in this circumstance fades over time. When you and the child are both adults, the relationship becomes more like one between friends. It has to be maintained through civility and reciprocity, and that’s difficult. To be real family, you have to raise your children. — Roger
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I’m an Ob-Gyn of 35 years writing with some advice: Anyone who produces sperm and wants to have sex with someone who has a uterus and who also never wants to father a pregnancy should get a vasectomy. It’s an extremely low-risk procedure with no stipulations except that the person getting the surgery be a legal adult, and it takes minutes. Of course the pregnant woman mentioned in this letter gets the final say and of course the letter writer’s son should be forced, at the minimum, to pay child support. This is not complicated. — Margot
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