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Robertson - discontinuity of interests

2009: Advance directives and personhood

Robertson is another theorist who recognises the possibility that the value-based interests of a competent individual may be radically different from the simpler, experiential interests of an individual with severe incapacity. He states:

The values and interests of the competent person no longer are relevant to someone who has lost the rational structure on which those values and interests rested. Unless we are to view competently held values and interests as extending even into situations in which, because of incompetency, they can no longer have meaning, it matters not that as a competent person the individual would not wish to be maintained in a debilitated or disabled state. If the person is no longer competent enough to appreciate the degree of divergence from her previous activity that produced the choice against treatment, the prior directive does not represent her current interest merely because a competent directive was issued.” (Robertson, 1999)

Whilst Robertson accepts that competent people may well have an interest in controlling their future, he is doubtful as to whether the advance decisions they take will necessarily reflect the best interests of their future self. He states that there may be a conflict between the interests of the past competent self and those of current incompetent self and that in such cases, there is a risk that the wishes of the competent self may be privileged. For this reason, he believes that advance directives may pose a threat to people with incapacity and consequently should not always be respected, particularly in cases where the patient clearly “has an interest in further life”.



Last Updated: Friday 09 October 2009


  • Acknowledgements

    Alzheimer Europe gratefully acknowledges the support of the German Ministry of Health for the implementation of the Dementia Ethics Network.
  • Bundesministerium für Gesundheit