Suing Your Children

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During a recent teaching trip to Singapore I learned about the country’s fascinating Maintenance of Parents Act, which went into effect in 1996.  The law allows Singapore residents over 60 who are unable to maintain themselves adequately to claim maintenance from their children, either in a lump-sum payment or in the form of monthly allowances. Cases are heard by a special tribunal that decides whether payment should be made and how much it should be, based on criteria including the parent’s financial needs and the child’s earning capacity and other financial obligations.

The maintenance claim may be dismissed if the children can prove that they were abused, neglected, or abandoned by their parents when they were young. The law stipulates that only the basic amenities and physical needs of the applicant including shelter, food and clothing are required. The maintenance is not linked to the parent’s previous standard of living.

Here’s how Walter Woon, professor of law at the National University of Singapore, who proposed the law as a member of Parliament, explained the moral perspective the law was based on:

“[The law] will reaffirm the notion that each individual has a responsibility to look after his parents. It is not society’s responsibility. Singapore is still conservative enough so that this idea is not objectionable to most people. The bill reinforces the traditional values of Christianity, Islam, Hinduism and Buddhism as well as Confucianism. It doesn’t hurt a society now and then to be reminded of what its core values are.

“Second, and more important, it will make those who are inclined to shirk their responsibility think twice. As things stand, if a person asks family members or clergymen or the Ministry of Community Development to help him get financial support from his children, the most that they can do is to try to mediate. The trouble with mediation is that the mediators have no teeth. They can exhort, preach, persuade, cajole, plead and even beg. But when push comes to shove, there is currently no way that a son can be forced to support his parents.

“But if there were a legal remedy, that would be a different matter. To be sued by one’s parents would entail a massive loss of face. It would be a public disgrace. The hand of the conciliator would be immeasurably strengthened. It is far more likely that some sort of amicable settlement would be reached through private mediation if the recalcitrant son knows that the alternative is a public trial. So, one hopes that the fact that such a law exists will make it unnecessary for it to be invoked.

. . . The law cannot legislate love between parents and children and husbands and wives. All the law can do is provide a safety net where morality proves insufficient. [It] won’t affect the people who already are supporting their parents, not only with money but, it is hoped, with love and respect. The only ones who need worry are those who aren’t living up to their moral obligations. If the law helps even one poor person, I think the effort is worth it.”

Twenty-nine states in the U.S. have similar laws, but whereas Singapore (population 5.3 million) has 100-to-150 cases per year, the U.S. laws are almost never enforced. When Pennsylvania court last year held John Pittas responsible for his mother’s $93,000 nursing home bill, it made the news.

His mother had been hospitalized after an automobile accident and moved back to Greece without settling her bill. There was no suggestion that he had been neglectful. The nursing home wanted to collect, and Pittas was held liable. The few cases that have come up in the U.S. are like Pittas – nursing homes or hospitals trying to collect bills. There are no cases I’m aware of where parents have sued for support.

Many years ago, in what turned out to be the last year of my father’s life, I persuaded him to move from Florida to Massachusetts, where I live. He was blind from macular degeneration and needed a supportive living environment — ultimately one with 24-hour nursing care available. I engaged a geriatric care manager to help me (his only child) scope out the options.

She told me about maneuvres that would allow him to receive Medicaid support. In the spirit of Professor Woon, I did not want to do that. The care my father needed was costly, but I could afford it, and it seemed obviously wrong to ask my fellow citizens to support him. If I had refused to pay for his support I would have regarded it as fair for Medicaid to come after me, as Professor Woon wanted the authorities to be able to do in Singapore. It didn’t seem right to me that you, through your taxes, should have had to pay for my father’s care if I was able to provide for him.

James Sabin, M.D., 73, is an organizer of Over 65 and a clinical professor of psychiatry at Harvard Medical School.

6 Responses to “Suing Your Children”

  1. Carol Levine

    I too was in Singapore last year, and the people I met with (elder care officials and caregiver advocates) were not at all supportive of this law. They pointed out that it was not so much shameful to the adult children (who had their own reasons for avoiding financial upkeep of their parents) as it was shameful to the parents, who had to admit to a local court that they had brought up ungrateful children. Also Singapore has a wide network of health care and social services that make these cases very rare. We have no such broad safety net, and what we have is disintegrating rapidly. It is admirable and fortunate, Jim, that you wanted to and were financially able to provide for your father (for one year?). What if you had to make a choice between a disabled child’s care and your parent’s? Would you have impoverished yourself to do this? Making a moral obligation into a legal one in this situation creates more injustice and fractures families. As a spouse, I would have had to divorce my late husband or claim spousal refusal for him to obtain Medicaid home care. Medicare and private insurance doesn’t cover long-term care. I did neither, but I would resist any efforts to make adult children legally responsible for long-term care in this country.

    • Jim Sabin

      Dear Carol -
      I’m sorry for the delay in responding.
      I did not get to meet with any members of the eldercare community in Singapore. I share their view that for parents to feel they must sue their children for support in order to meet their basic needs reflects a tragedy within the family and wider society. “Rare” isn’t a precise term. Scaling up the number of such suits brought in recent years in Singapore to the US population would mean 6,000 – 9,000 episodes of litigation per year. To me that’s not an insubstantial number.
      The rationales for the decisions made by the special court are not publicly available, so I don’t know how the law is actually interpreted and applied. The law itself asks the court to take the situation of the children into account. I would expect and hope that caring for a disabled child would be seen as a mitigating circumstance. The sponsor of the law saw it as a support for the Confucian moral code, not a replacement of it or of a societally provided safety net. He “hope[d] that the fact that such a law exists will make it unnecessary for it to be invoked.”
      The fact that the only applications of the laws we have in 29 states have been taken by institutions seeking to collect on “bad debt” suggests that there’s a wide consensus in agreement with your view that children shouldn’t be made legally responsible for long term care. Staying with my personal experience, if the mitigating circumstances of the kind you imagine did not apply, I would have regarded a legal expectation for me to take financial responsibility as an ethically appropriate outcome. If we as a nation chose to provide a strong societally based safety net and finance it with tax revenues based on a properly graduated income tax, I agree that this would be a preferable approach to applying the kind of law I learned about in Singapore.
      Thank you for your thoughts on these issues!

  2. Steve Moffic

    Now this possibility seems to be spreading to China, as I noticed today on an article in the Chicago Tribune titled “China will let parents sue for neglect”. This law will begin July 1, so there is obviously no track record so far. Part of the reasoning for the law is that China’s aging problem may dwarf even ours, especially as children have moved to the cities and left their parents to fend for themselves in the country. It seems like a legal attempt to reintegrate the Confucian philosophy of filial piety and care. How this new expectation will be able to mesh with the results of the one-child laws and unexpected economic growth will be important for the world to follow.

    • Jim Sabin

      Hi Steve
      Thank you for bringing the new law in China to my attention. It will indeed be interesting to see how the law – and, more broadly, care for the older population – plays out in China. The combination of the one child policy and the increased migration to the cities creates the potential for a great deal of isolation for the elderly. As Carol Levine pointed out in her comment above, we in the U.S. have not followed the route of enforcing responsibility for one’s parents. My guess is that before too long we’ll see some cash strapped states that have parental support laws on their books applying them to children of parents who have been receiving state supported services.

  3. Philip A. Rozario

    Hi Jim,

    Great article. The idea of family responsibility is attractive especially in a society that promotes familism, such as Singapore. However, the reality in Singapore is different. Parents who are “forced” into using this law often have extremely limited income themselves. As Carol Levine points out, parents who most need financial support and are not receiving it from their children are most averse to using the law because of shame and also the fact that such legal actions can further damage the already frayed relationship with their adult children and grandchildren. Further the maintenance that they receive is often insufficient. In 2010, I spend a few months of my sabbatical research the law and its impact on social workers and to examine parliamentary reports on the law. I’ll be happy share them with you or anyone else.

    • James Sabin

      Hi Philip
      Thank you for this comment. What a great sabbatical project! I think of the law more as a statement of values than as a solution to the problem of support for the elderly. As you and Carol both point out, invoking the law points to a sad breakdown within a family. Ideally, we’d see collaboration between the generations on behalf of the most dignified attainable life for the elderly. If both generations are poor, rather than having them battle each other for the limited family resources, in a society as wealthy as Singapore there would probably be ways for parents and children to work together to identify external sources of funding.