Experimental Philosophical Bioethics, Advance Directives and the True Self in Dementia

In Kristien Hens & Andreas De Block, Advances in experimental philosophy of medicine. New York: Bloomsbury Academic. pp. 259-284 (2023)
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Abstract

In the present chapter, we seek to better understand how lay people reason about the “true self” of a person with advancing dementia. We are also interested in how such reasoning bears on laypeople’s views about the validity or invalidity of an advance directive (AD) regarding that person’s treatment. Toward that end, we will report the results of two empirical studies we undertook to gain insights into this relationship: namely, between judgments about the true self and whether to follow an AD. We find that many participants judge that a hypothetical person with dementia, stipulated to be non-autonomous with respect to her healthcare decision-making, is nevertheless still her “true self” and that her current apparent preference (to be treated) should be honored despite conflicting with the autonomous preference (not to be treated) previously recorded in her AD. We discuss potential normative implications of our findings, drawing on arguments from the emerging literature on experimental philosophical bioethics, also known experimental bioethics or “bioxphi.”

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Brian D. Earp
National University of Singapore
Ivar Hannikainen
Pontifícia Universidade Católica do Rio de Janeiro

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