While most filial responsibility laws contemplate civil enforcement, some include criminal penalties for adult children or close relatives who fail to provide for family members when challenged to do so.
[2][3] At one time[year needed], as many as 45 U.S. states had statutes obligating an adult child to care for his or her parents.
Some states repealed their filial support laws after Medicaid took a greater role in providing relief to elderly patients without means.
Should the children fail to provide adequately, they allow nursing homes and government agencies to bring legal action to recover the cost of caring for the parents.
In 2012, the media reported the case of John Pittas, whose mother had received care in a skilled nursing facility in Pennsylvania after an accident and then moved to Greece.
[13] Singapore, Taiwan, India, and Mainland China criminalize refusal of financial or emotional support for one's elderly parents.