Till Health Do Us Part: An Urban South African Autoethnography of Maternal Ethical Exit and Moral Loneliness

Abstract

Mental illness within families reshapes care, moral responsibility, and everyday life, particularly in African contexts where mental health support is limited, and caregiving remains gendered. Drawing on African feminist scholarship, this paper uses ethically masked autoethnography to examine how care, danger, and maternal ethical decision-making unfolded within an urban South African household affected by severe mental illness. The analysis shows how mental illness reorganised domestic life, transformed caregiving into vigilance and risk management, and redistributed ethical responsibility. It explores how maternal responsibilities were renegotiated when endurance became unsafe for children and institutional, familial, and religious supports failed. The paper makes one primary conceptual contribution: maternal ethical exit, which theorises withdrawal from co-residence not as abandonment but as an ethical reconfiguration of care oriented toward protection under conditions of danger. It also uses moral loneliness as an analytical formulation for the experience of carrying consequential ethical responsibility without adequate shared witnessing, validation, or collective support, bringing this formulation into dialogue with African feminist anthropology, family caregiving, severe mental illness, and maternal decision-making. Drawing on African feminist anthropology, feminist ethics of care, the anthropology of mental health, and scholarship on everyday religion, the paper argues that care cannot be reduced to sacrifice, endurance, or continued proximity. It further demonstrates how spiritual rupture and ancestral reorientation emerged as forms of moral grounding amid institutional collapse. Methodologically, the paper shows how relational masking, selective disclosure, and reflexive restraint can enable autoethnographic inquiry into intimate suffering while reducing risks to those represented.