Autonomy, Beneficence, and the Permanently Demented

Abstract

Ronald Dworkin contends that advance directives, written when fully competent, concerning how one should be treated if one becomes permanently demented ought to be honored -- even if once demented, one protests against them. His arguments rest on views concerning autonomy and duties of beneficence. I argue Dworkin's conception of autonomy is overly narrow. Another conception of autonomy as self-control is developed that provides reason to give some weight to what one's demented self chooses. Further, I argue his claims about duties of beneficence are at odds with his claims about how to treat beliefs about the sanctity of life.