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Notes -
I don't want to oversimplify, but from everything I've read and experienced, the answer to raising healthy children can be summed up as 'spend time with them'. Children can be raised with all manner of philosophies, and as long as they have adults who care about them and give them attention, they'll almost certainly be okay.
That gives you an easy answer for what you should do as well. If you want to adopt, or by miracle conceive with your partner, you'll have to sacrifice what your life looks like now to make space for the child - and that's it. Whatever else you decide to do will probably be fine. Likewise, if you don't have a child of your own, you can make an effort to be part of the lives of children in your family or your community. Maybe it's too late for your sister's kids, but children at large are in desperate need of responsible adults who give a damn about them. As for rotting in old age - I dunno, if you don't want to connect with the younger generation, I guess you could make friends?
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