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Buchanan - psychological continuity and personhood

2009: Advance directives and personhood

According to Buchanan (1988), as long as strong connections exist between the person who wrote the advance directive and the current self, advance directives should be used. However, there may come a time when the person has lost not only connections or similarities with their former self, but no longer has any kind of continuity with people in general. Buchanan uses the term “non-person” to describe people who in his eyes have reached this stage. Of course, one could argue that there is more to personal identity than psychological continuity. Moreover, one cannot claim with any degree of certainty that a person with dementia even in the latest stages is unable to experience any psychological states. As pointed out by Kuhse, people with severe dementia are capable of experiencing states of consciousness and have interests

Buchanan criticises the psychological view of personal identity stating that “the very process that renders the individual incompetent and brings the advance directive into play can – and indeed does – destroy the conditions necessary for his or her personal identity and thereby undercut entirely the moral authority of the directive.” In his view, the advance directive serves to protect the interests of the author of the advance directive, which have much greater moral weight than the experiential interests of the “non-person that succeeds” them.



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