Some Reflections on the Problem of Advance Directives, Personhood, and Personal Identity

In this paper, I consider objections to advance directives based on the claim that there is a discontinuity of interests, and of personal identity, between the time a person executes an advance directive and the time when the patient has become severely demented. Focusing narrowly on refusals of lif...

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Bibliographic Details
Published in:Kennedy Institute of Ethics journal 1999-12, Vol.9 (4), p.347-364
Main Author: Kuhse, Helga
Format: Article
Language:English
Subjects:
Advance Directive Adherence
Advance Directives
Bioethics
Decision Making
Dementia
Ethics
Euthanasia, Passive
Freedom
Homicide
Humans
Individuality
Life Support Care
Mental Competency
Pain
Palliative Care
Personal Autonomy
Personhood
Self Concept
Social Values
Time Factors
Treatment Refusal
Value of Life
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Summary:In this paper, I consider objections to advance directives based on the claim that there is a discontinuity of interests, and of personal identity, between the time a person executes an advance directive and the time when the patient has become severely demented. Focusing narrowly on refusals of life-sustaining treatment for severely demented patients, I argue that acceptance of the psychological view of personal identity does not entail that treatment refusals should be overriden. Although severely demented patients are morally considerable beings, and must be kept comfortable whilst alive, they no longer have an interest in receiving life-sustaining treatment.
ISSN:1054-6863
1086-3249
1086-3249
DOI:10.1353/ken.1999.0027