Some reflections on the problem of advance directives, personhood, and personal identity

In this paper, I consider objections to advance directives based on the cla im that there is a discontinuity of interests, and of personal identity bet ween the time a person executes an advance directive and the time when the patient has become severely demented. Focusing narrowly on refusals of life -sustaining treatment for severely demented patients, I argue that acceptan ce of the psychological view of personal identity does not entail that trea tment refusals should be overridden. Although severely demented patients ar e morally considerable beings, and must be kept comfortable whilst alive, t hey no longer have an interest in receiving life-sustaining treatment.