Families have always engaged in moral discourse when confronted by the challenges of chronic illness. We cannot avoid addressing the ethical and moral judgments and dilemmas that are such an important dimension of the illness experience. Our and our families’ questions about who is responsible for whom, for example, go to the heart of defining a family’s ethos. Its everyday moral vocabulary includes should and ought, commitment and responsibility, owing, shame, tragedy, and pity.
Our families not only join together in moral “polylogues,” with all the passion and pain that situations that really matter evoke. They also demonstrate in a mostly unheralded way the four classical virtues of courage, phronesis, temperance, and justice. We show courage as we accept and withstand the losses and suffering that are common companions to illness. We exhibit a sense of justice when we make the inevitable choices about the allocation of resources, whether of time, money, or attention. People struck by misfortune are commonly forced to select among incommensurable goods as they attempt to salvage something from their previous lives. How can one quantify who is more deserving of this or that support, aid, or companionship?
Our family members demonstrate phronesis— practical wisdom—when they decide whom to include in their conversations about proper care and how to develop and follow through on a sound course of action. Temperance is the virtue on display when individuals and families attempt to balance all these concerns and share the weight of their burdens. The language of virtues is a lovely one with which to reflect upon and discuss how people attempt to solve the difficult problems in their lives.
“What is the right thing to do?” and, “What kind of person (father, mother, son, daughter) do I wish to be?” are moral questions. In the course of everyday life, our behavior implicitly poses such questions, with little reflection on our part. It is through the answers we receive, from others as well as ourselves, that our character, self, and family are formed.
In Erik Erikson’s psychosocial view of personal development thr0ugh the life cycle, for example, identity formation is at bottom a process of building character. The ability of our family and community to help us through our developmental crises lays the foundation for the emergence as we age, of hope, will, purpose, competence, fidelity, love, care, and wisdom. Our family, then, is a moral and ethical milieu in which we learn from each other a sense of fairness, reciprocity, generosity, and commitment.
We find ourselves in families, whether one or many, bound by ties of kinship, marriage, intimacy, and responsibility. Receiving life, care, and opportunity from our parents, participating in the give and take of family life, expressing vows of marriage and fidelity, bringing children into the world, initiating and sustaining friendships and drawing new people into the web of family relations—these are among the many events that confer ethical obligations upon ourselves and others.