Persons, Authority, and Advance Directives

I aim to clarify the moral authority of an advance directive that pertains to one’s later dementia-afflicted self. I develop the principle of Unity-Relative Autonomy, according to which the basis of self-governance is psychological unity rather than personal identity, and, on these grounds, argue that such advance directives have minimal weight grounded in respect for autonomy. I, nonetheless, suggest that bodily sovereignty should be distinguished sharply from autonomy, and I maintain that one has a moral claim to decide the fate of one’s later body. Lastly, I consider but reject the idea that such advance directives could have surrogate decision-making authority.