Ethical Theory and Moral Practice 7 (3):267-291 (2004)

Authors
John K. Davis
California State University, Fullerton
Abstract
Honoring a living will typically involves treating an incompetent patient in accord with preferences she once had, but whose objects she can no longer understand. How do we respect her precedent autonomy by giving her what she used to want? There is a similar problem with subsequent consent: How can we justify interfering with someone''s autonomy on the grounds that she will later consent to the interference, if she refuses now?Both problems arise on the assumption that, to respect someone''s autonomy, any preferences we respect must be among that person''s current preferences. I argue that this is not always true. Just as we can celebrate an event long after it happens, so can we respect someone''s wishes long before or after she has that wish. In the contexts of precedent autonomy and subsequent consent, the wishes are often preferences about which of two other, conflicting preferences to satisfy. When someone has two conflicting preferences, and a third preference on how to resolve that conflict, to respect his autonomy we must respect that third preference. People with declining competence may have a resolution preference earlier, favoring the earlier conflicting preference (precedent autonomy), whereas those with rising competence may have it later, favoring the later conflicting preference (subsequent consent). To respect autonomy in such cases we must respect not a current, but a former or later preference.
Keywords advance directive  autonomy  hierarchical theory of the will  living will  precedent autonomy  prospective autonomy  self-paternalism  subsequent consent
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Reprint years 2005
DOI 10.1023/B:ETTA.0000042908.13784.00
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References found in this work BETA

Freedom of the Will and the Concept of a Person.Harry G. Frankfurt - 1971 - Journal of Philosophy 68 (1):5-20.
Freedom of the Will and the Concept of a Person.Harry Frankfurt - 2004 - In Tim Crane & Katalin Farkas (eds.), Metaphysics: A Guide and Anthology. Oxford University Press.
Freedom of the Will and the Concept of a Person.Harry G. Frankfurt - 2003 - In Gary Watson (ed.), Free Will. Oxford University Press.

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Citations of this work BETA

Three Arguments Against Prescription Requirements.Jessica Flanigan - 2012 - Journal of Medical Ethics 38 (10):579-586.
The time of one's life: views of aging and age group justice.Nancy S. Jecker - 2021 - History and Philosophy of the Life Sciences 43 (1):1-14.
Autonomy and the Moral Authority of Advance Directives.Eric Vogelstein - 2016 - Journal of Medicine and Philosophy 41 (5):500-520.
Fickle Consent.Tom Dougherty - 2014 - Philosophical Studies 167 (1):25-40.

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