Families as caregivers: the limits of morality.

There is a developing trend to look to families to provide care and support of those in need of rehabilitation. A widespread assumption is that family care is superior care and, with modest degrees of support, families can provide that care. Yet we may question the ethical limits of the obligation of a family or family member to provide care when the demands are severe. Psychologic and moral problems that confront caregivers are examined. In some cases caregivers must sacrifice their present and future welfare. That the moral claim made upon them may seem a justifiable one in many respects does not mean that it will be endurable; that it is endurable does not mean that it is justifiable. The problem is exacerbated by lack of a supportive culture, one that rewards and honors those who take on heroic duties. Caregivers may be socially isolated. If heroic demands are to be made on family members, a richer moral culture is required, not just the provision of improved social services.