Journal ArticleDOI
Second Thoughts: Revoking Decisions Over One’s Own Future
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In this article, the authors argue that when a voluntary commitment is made, freely, on the basis of principles, and with alertness to the possible consequences which might ensue, it should be honored.Abstract:
In asking questions about a person's right or authority to decide for his or her future self, we are tempted to invoke a Parfitian metaphysic of separate selves. Successive selves here are not merely a useful figure of speech such as Elster and Schelling employ, but a moral guide.' 2 Such thinking invites a rather standard alignment: advance directives are morally binding while traditional notions of personal identity prevail, but when with Parfit we countenance a succession of selves inhabiting the same body, we are drawn to question whether the decision of one self could bind the subsequent action of another.3 Although I would not deny the force of the second of these tenets, I am loathe to accept the first. Exotic metaphysics aside, there are very strong reasons to doubt the moral force of decisions we may make and later reconsider about what we are to be, or to do, at some time in the future. A central expression of autonomy is found in our ability to make a plan for ourselves and adhere to it. Emphasizing this view, Joel Feinberg argues that when a voluntary commitment is made, freely, on the basis of principles, and with alertness to the possible consequences which might ensue, it should be honored.4 He quotes with approval from Arneson, "The root idea of autonomy is that in making a voluntary choice a person takes on respon-read more
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Journal ArticleDOI
Precedent Autonomy and Personal Identity
TL;DR: It is shown that categorical objections to advance directives and "Ulysses contracts" are based on false assumptions about personal identity that conflate persistence and biographical identity and that advance directives are an ethically respectable tool for prolonging individuals' autonomy in cases of dementia and mental illness.
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Coercive treatment and autonomy in psychiatry
Manne Sjöstrand,Gert Helgesson +1 more
TL;DR: It is argued that non-autonomous patients can have reasons, rooted in their deeply-set values, to renounce compulsory institutional treatment, and that such reasons should be respected unless it can be assumed that their new predicaments have caused them to change their views.
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Fluctuating capacity and advance decision-making in Bipolar Affective Disorder — Self-binding directives and self-determination
Tania Gergel,Gareth Owen +1 more
TL;DR: It is argued that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician–patient relationship, could represent a legitimate and ethically coherent form of self-determination.
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What are the ownership rights for gametes and embryos? Advance directives and the disposition of cryopreserved gametes and embryos
Journal ArticleDOI
Making a clean break: addiction and ulysses contracts
TL;DR: There is an important place for Ulysses contracts in coping with addictive behaviour that stems from certain problematic preference structures, and interference based on a Ulysse contract need not involve questionably favouring an agent's past preferences over her current preferences, but can actually be justified in terms of the agent's current concerns and commitments.