The article discusses a study that found adult children who were abused as children and later became caregivers for their parents were more likely to experience depression. In particular, those who cared for their abusive parent had the strongest link to depression symptoms. The study highlights the difficult ethical dilemma faced by abused adult children who must decide whether to care for parents who abused them.

1. Paula Span | The New York Times, January 20th 2014

2.  “Adam from Phoenix spent his childhood
traumatized by his parents’ abuse. ‘They remain
unapologetic, and I’d gladly let them rot if they
one day could not fend for themselves,’ he wrote.
Yet we also heard from people who had agreed
to become caregivers even if their parents had
been, or remained, abusive. ‘I live by a moral
code,” said Minerva from New York City, who
cared for her alcoholic and bipolar mother. “It
was my responsibility and I stepped up to the
plate.’”

3.  Helen S. from Connecticut supervised her angry,
meddlesome mother’s care and had lunch with
her nearly every Sunday until she died. “I felt I
had done the decent thing, and it helped me to
put the remaining anger and resentment to rest,”
Helen wrote. We know relatively little about how
many adults become caregivers for abusive or
neglectful parents, or about why they choose to
— or not to. But thanks to a recent study, we can
see that those who report having endured
childhood maltreatmentare particularly
vulnerable to depression if they later care for
their parents.

4.  The researchers divided their sample into
three categories: those with no history of
childhood abuse or neglect; those who had
been abused and were caring for their non-
abusive parent; and those who had been
abused and were, to borrow the study’s
memorable title, “caring for my abuser.” They
also compared caregivers neglected as
children with those who were not neglected

5.  Those who had been abused or neglected
were more likely to have symptoms of
depression — like lack of appetite, insomnia,
trouble concentrating, sadness and lethargy
— than those who had not been. No surprise
there, perhaps.But the link was strongest for
the third category. “The key was caring for
the abusive parent,” said the lead author,
Jooyoung Kong, a doctoral candidate in social
work. Years later, “they are still affected.
They’re more depressed.”

6. Like many studies, this one raises questions as well as
answers them. Its definition of caregiving — having
ever provided personal care to a parent for a month
or longer — could have included all kinds of
arrangements. “It doesn’t measure how long ago they
provided care, or whether they lived with a parent or
not,” Ms. Kong said. She plans to include details from
other surveys as her research continues. But the
study does indicate that caregivers with a history of
maltreatment should be aware of the risk they are
taking — and, if the strain of caregiving becomes
overwhelming, the increased risk that they will abuse
their charges, perpetuating a sorrowful cycle.

7.  “It’s such an untenable position to be placed in,”
Dr. Moorman said. “My guess is, people only do it
if they’re forced to, if there’s no one else to do
it.” People in that situation should “be aware of
the signs and symptoms of depression,” she said,
and seek therapy or find a support group. The
rest of us are hardly in a position to judge those
who walk away. But our society’s overreliance on
unpaid family caregiving can make that difficult
to do. As Dr. Moorman pointed out, “Not only
nice people get old.”

9.  What is the main ethical conflict (or conflicts)
that you sense in this article?

10.  Do children have a familial duty to care for
their parents? Why or why not?
 How much should parental behavior factor
into this (perceived) duty?

11.  Health care personnel are generally required
to treat the patients that come before them,
regardless of who they are or what they have
done. What are your thoughts on this
requirement, and the effect it may have on
health care personnel?

12.  Should physicians be able to exercise their
right of conscience in determining who they
treat?
 *right of conscience: the right of a physician
(in this context) to refuse an action that is
generally required of them.

13.  How can we help alleviate the suffering of
children who are placed in this situation? Is
alleviating this kind of suffering a duty that
society (or whatever sector of society you
have in mind) should take on?

14.  On a more abstract level, do abusive parents
deserve to be cared for?

15.  Do you have any final thoughts on this
article?
 What did you learn from this article?