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Respect for Other Selves
- Kennedy Institute of Ethics Journal
- Johns Hopkins University Press
- Volume 21, Number 4, December 2011
- pp. 349-378
- 10.1353/ken.2011.0017
- Article
- Additional Information
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Philosophers have mostly advocated that advance directives should bear the same authority, with regard to refusal of life-extending treatment, as a patient's contemporaneous consent or refusal. Such authors typically support this position through a theory of persistent personal identity. I agree that the loss of mental competence does not render someone a moral stranger to their prior goal but argue that equating advance direction with consent is to ignore the capacity of nonpersons to attribute and withhold moral value. A distinction should be drawn between advance directives that seek to pursue deeply held goals and those that express contempt for the mentally incompetent.