Abstract

Definition of the problem “Ulysses contracts” are advance directives by means of which a patient authorizes compulsory treatment for a phase of a temporary inhibition of competence. Ethical discussion of Ulysses contracts usually focuses on the question of the “moral authority” or the “binding force” of Ulysses contracts, i.e., of whether Ulysses contracts should be honored or whether the competent patient’s prospective wishes for compulsory treatment are overridden by the patient’s actual preferences in the situation of treatment. Arguments In this contribution, I argue that, even if the Ulysses contract undoubtedly applies to the actual situation, there may be reasons for not acting upon it. The main argument is that acting in conformity to a Ulysses contract may be justified but nevertheless wrong. After some terminological clarifications, I argue that Ulysses contracts justify the use of compulsory treatment but do not necessarily make it the right course of action. They authorize physicians to act in accordance with the patient’s advance directive and, thereby, protect them from blame and sanctions in case they administer compulsory treatment. Whether compulsory treatment is right or wrong, however, hinges on whether the patient retrospectively consents to it. It may be the case that administering compulsory treatment in conformity to the Ulysses contract is justified but turns out to be wrong if the patient does not retrospectively consent to it. It may also be the case that not obeying the Ulysses contract turns out to be right if the patient retrospectively consents to not following it. Conclusion In view of this, I conclude that Ulysses contracts should not be seen as morally binding and that they should not be made legally binding. They are not normatively on par with other advance directives that relate to, for example, states of dementia.