Murder by Omission: Reflections Sparked by a News Story About an Elderly Dementia Patient

Some news stories, when we read them, we always assume they’re “somebody else’s business.” Only when such a thing truly happens near you—to someone you know—do you suddenly realize that things like that really can happen.

A Heartbreaking Story

There was an elderly couple, both suffering from severe dementia, left by their grown children to live alone out in the countryside. Day to day, the children only hired someone to deliver boxed meals; almost all other care was left undone. Because of their dementia, the two of them could no longer manage their daily lives, and their living environment gradually fell into disorder.

During Lunar New Year, the children went back for a meal together, yet thought little of it, each assuming that caring for their parents was the others’ responsibility. Someone even suggested simply asking the Social Affairs Bureau (the local government agency for social welfare) to step in and arrange placement for the two elders.

Later, one of them fell, was injured, and passed away, while the other—being demented—had no idea that the lifelong companion at their side was gone, and so had no way to call for help. It wasn’t until a neighbor sensed something was wrong and went inside to check that they discovered one elder had already been dead for days, while the other had simply kept watch alone beside them, with no one to care for them. Only then did the neighbor hurry to contact the children.

(The original account involved a good deal that is too painful to look upon; I’ve deliberately held back here, keeping only the outline of what happened.)

“Doing Nothing” Can Be a Form of Harm Too

There’s a concept in law called an “offense by omission.” Put simply, when a person owes a duty to protect or care for another, yet—being in a position to act—chooses not to, and thereby causes that person harm, this “doing nothing” can itself give rise to legal liability.

Parents toward their minor children, and adult children toward parents who are incapacitated or demented—both, in law and in ethics, bear a certain duty of support and care. When that duty is set aside, whether deliberately or carelessly, and the situation is allowed to deteriorate, that outcome of “having lifted no hand, yet having caused harm” is not excused simply because “I didn’t actually do anything.”

This is precisely the point in the story that left me unable to settle for a long time: what is truly fatal is often not some single violent act, but prolonged indifference and buck-passing.

A Few Things to Keep in Mind

Dementia causes a person’s cognitive abilities to deteriorate severely, to the point of needing almost total care from others. This isn’t a case of “deliberately refusing to cooperate”; it’s the cruelty of the illness itself. Understanding this is the starting point of caregiving.

I’ve also always believed that when a family ends up treating its elders in an almost “penned-in” way, what lies behind it is usually a bond that, over long years, has grown as distant as that between strangers. Emotional estrangement isn’t created in a day, but the consequences it brings can be heavy beyond repair.

So character education and the right attitude toward caring for our elders really must be taught from an early age. This is not only for the elders’ sake, but also so that the next generation understands: care and companionship have never been responsibilities that can be outsourced or pushed onto someone else.