Powerful political and psychosocial processes influence the extent to which society recognises and responds to its members as kin. There are difficult ‘edges’ at which goodwill and rejection compete for dominance in the public mind. Health and social care staff are frequently working at these edges. This can overlap with, complicate and amplify the powerful emotions and relationships that are described in Chapter 5. Sometimes the dilemma is pretty obvious – the violent drunk haemorrhaging in an accident and emergency department inevitably arouses conflicting responses; the mother who continues to get herself pregnant despite all her previous infants being taken into care. The continued, often dangerously fluctuating, needs of old people with long-term conditions persist in frustrating our wish to remove suffering and can wear us down. Our generosity competes with our instinct to turn away, to recoil, even to punish.