The circumstances of the three characters are so altered after the accident that Ethan's feelings for Zeena and Mattie almost don't matter. These are the new facts of life -- Zeena is well enough to care for Mattie in her recuperation and they have lived this way for the last 20+ years. Mattie is a changed woman after the accident, much more bitter and resentful of the pain and misery she is in. She is no longer the light, lovely, youthful joy that Ethan fell for. He is not only a prisoner to Zeena, he is a prisoner to Mattie as well. For the same reasons of integrity that he couldn't leave with Mattie in the first place, he is stuck in this situation now. Mrs. Hale's remarks in the last chapter surely leave us to have sympathy for Ethan, perhaps more than the two women. The Frome home has been a place of misery and discontent for a very long time. Any love is gone, this is just existence now.