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You've all been very helpful on this subject, I now have a fuller picture, filled in from another family member. My MIL, 80, is a lifelong hypochondriac. She goes to the ER, taken by my BIL, at least once a month since I've known her, 10 years or so. In August, she had open heart surg. for a dissected aorta. She had a small stroke right after surgery, lost her sense of taste (temporarily) and became incontinent. She is in a rehab facility but refusing rehab. BIL says he wants to "honor his mother's wishes". She wishes to die. But she's not dying of anything. My husband and I have offered some suggestions for treatment, I have a friend who is a gerontologist who practices at the center where she is, offered to follow up on paperwork, etc. He keeps talking about "malpractice" and that the doctors are doing things that are "actionable"...i.e., they are trying to treat his mother, not neglect her. She says she wants to starve herself to death and is refusing food and all meds except for pain. (what pain? she has a UTI). My husband wants me and us to back out of the situation and let the cards fall where they may...but this lady could live for YEARS in a debilitated state, and I don't want someone to turn around and say that we are in any way then responsible for her care and or upkeep when she's made this bed herself, with the help of her son. Can I ethically walk away from this situation? I appreciate all the wisdom on this board and really want your input.

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In the end it depends on how hard you want to fight the brother-in-law and mother-on-law. Legally, she has the right to make her own decisions and I'm not sure what you can do to change that. There's some chance that if no one is fighting with her she may give up the attention getting device of refusing to eat and begin to get better.
If she had dementia, you could fight for custody, which is expensive and you may not win since the brother-in-law has equal rights with your husband. Also, you really can't force her to eat anyway, so I'm not sure you'd gain much.
Please don't feel guilty - it sounds as though you are/have been trying your best and getting nowhere. Backing off may be all you can do. The results could be that she gives up and starts eating or else (unlikely, I think) she could starve. But the wish to die needs to be very strong to do that and she doesn't sound sick enough to stick it out. You might want to discuss this with a chaplain at the hospital, your church or your local hospice. They could help guide you.
Take care,
Carol
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Personal ethics are tricky, because they are personal. The ethics you need to consult are your own and the ethics you share with your husband. I have been married a long time, so long I don't recall when it was we came to the conclusion that each of us would be the final say in our own family's situations. Respecting that final say is an ethical issue and not always easy.

Recent trivial example: His elderly great-aunt was coming to visit, his mother's first visitor since we relocated her to a NH in our state. She's a conservative Baptist, he brews home beer and stores it in a corner of the guest bathroom. He asks me, "should I put the beer somewhere else?" I reply, "its up to you, its your family."

When you practice on little issues for 30 years, it is easier to support them on the bigger issues of "what to do with demented Mom and Dad".

While there are definite situations that require a joint consensus - where mutually owned assets are involved, possible harm to marital harmony, etc. Many situations can be solved by allowing the spouse whose family is involved to make the final call and employing your personal ethics to support that decision -as you won't always agree with a spouse's decision.

While it is not easy to back off when your spouse and their entire family may be wrong, let's say (purely for speculation purposes:) frequently so, but your marriage and marital harmony should be your priority - now that's a bit of my ethics being shared with you.
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Your question was can you ethically walk away from the "mess". Sure you can. And it looks like your husband is wanting to do just that. After watching the drama unfold year after year it gets to be too much to continue on with. Are you and/or husband POA? If not, then no one will ever come back on you for taking the responsibility of mil. Plain and simple....she is not your responsibility so allow things to unfold as they may. It's going to save you a lot of headaches and heartaches along the way. She isn't going to starve. That sounds like another way to control you. The only problem she may face is that in refusing rehab she may be told that she will have to find another facility. Sorry to be so blunt, but mil sounds like a cranky old woman who uses "illness" to control those around her to get her way. You don't have to ask "how high" when she says "jump".
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Isn't it just awful when we get put in the situation where we must make a decision like this? Remember that those guilty feelings are controlled by you and you alone. And when you allow yourself to feel that way you are falling into the trap that mil has laid for you. You feel guilty, do what she wants, things fall apart and she then comes back with "who me?" I didn't do anything. Here is what I do when faced with a decision.....write down on one side of the paper the pros in taking over mil's care....the other side write down the cons. And be honest with your answers. Then get a good night's sleep and make your choice when you are mentally rested.
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Legally, I doubt there is very much you could do. Adults are allowed to make their own decisions -- even bad decisions -- unless they are incompetent in the legal sense. I have no doubt that your MIL has mental health issues, but I don't think hypochondria is grounds for declaring someone incompetent.

Ethically, I don't think people are responsible for doing what they have no power or authority to do.

Can you walk away with a clear conscience? What else can you possibly do?
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Thanks to you all for relieving my conscience. Yes, she is a cranky old woman with lots of control issues. I think that makes me feel guilty.
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You are caught between ethics and morality and it all has a legal implication. Ethically, do what is right, but morally follow your heart and wisdom based on knowledge of the lady. Maybe she should just have palliative care and not rehab / curative measures? And that's a way to find out how deep her convictions are and if she is indeed playing on your emotions and trying to control you. While she is competant she can make her own decisions, but to go on palliative care she needs commit on paper that she does not want curative measures. Her pain can be controlled, and there are different types of pain including psychological pain she may e experiencing, who knows. You can also have a social worker talk with her. Good luck
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