Siblings to a child with physical illness risk feeling overlooked and feeling like their parents have no time for them. Siblings are often in need of attention, but at the same time they try not to draw attention to themselves to avoid being a burden in a family that is already under severe stress. The consequences that the illness has for siblings risk having a negative impact on their development. Even though this is generally acknowledged, siblings to children with physical illness risk being overlooked in practice. Existing research tends to focus on identifying consequences and on the family context, which has made us consider how the societal conditions in Denmark affect siblings' conditions for development. To examine development from a contextual perspective we have chosen Urie Bronfenbrenner’s ecological theory of development. We believe that this focus on the context can contribute to a perspective that is unexplored so far. On the basis of this the present theoretical study examines the following: how can we from a macrosystemic level understand the conditions for development for siblings to children with physical illness? Physical illness is understood as having a chronic disabling nature, and we have chosen the family as our secondary analytical object. The study is theoretical and eclectic, which means that we include other theoretical concepts to complement Bronfenbrenner’s ecological theory and help us get a broader understanding of siblings’ development.

First we present the consequences that siblings can experience based on the general understanding within research. In the following chapter we describe Bronfenbrenner’s ecological theory of development, and clarify that we use the final version of the theory. We present Bronfenbrenner's conceptualisation of development and describe the individual, and the micro-, meso-, exo-, macro- and chronosystem as well as the connection between them all. In the analysis the purpose is to analyse three different macrosystemic aspects that influence siblings’ conditions for development contextualised in the danish welfare state. First we analyse how different discourses concerning the modern life of children create conditions for siblings’ development. We present conflicting discourses and argue that siblings have difficulties living up to what is expected of them based on these discourses. In continuation we analyse how discourses specifically in regards to siblings create different rights and duties. Secondly we analyse how characteristics of parenthood affect siblings' conditions for development. Overall we argue that parents are under pressure when it comes to living up to the expectations, which has a negative impact on siblings' conditions for development. Third we analyse how the treatment of physical illness creates conditions for siblings development.

Afterwards the discussion follows. Firstly we discuss the interaction between the three aspects of the analysis and argue that they overall seem to create undesirable conditions for siblings’ development. On the basis of the analysis we consider if the role of parents tends to be exaggerated. Then we discuss siblings' tendency to take on adult tasks and finish asking whether we should expect everything to be ideal for siblings.

We continue with a discussion of intervention, with the aim of getting an understanding of how we can improve siblings' conditions for development. First we present and discuss the present interventions that exist. We then present three supplements to the existing intervention to help siblings based on the macrosystemic analysis. We discuss how registrations of siblings in the healthcare system could benefit, how a more holistic approach in the healthcare system could be positive and how awareness of discourses can help. In the last part of the dissertation we discuss the methodological choices we have made and reflect upon this. Firstly we discuss four different aspects in relation to using Bronfenbrenners’ theory. Afterwards we discuss two alternative perspectives that could have been used to examine the topic. We finish by discussing our personal influence on the dissertation and what contributions the dissertation offers.

In conclusion the present dissertation emphasises the importance of a contextual perspective in relation to siblings’ conditions for development. The macrosystemic aspects examined create undesirable conditions for siblings and in general the dissertation argues for a more broad perspective on development. There needs to be an understanding and acceptance of illness as an inevitable risk factor and therefore there needs to be a focus on how to create better developmental conditions in spite of that risk.