PHIL276 Language in Society
patients cannot exist over time . This I disagree with . If anything , it can be used to strengthen my argument further . There is no denying that for the most part demented patients do have phases of consciousness , the problem is that they are separate ( in most cases ), there is nothing tying Margo ’ s eating sandwiches one minute to her being in bed the next , for example . If anything , since the capacity for conscious experience is there , we could make the radical inference that there are many Margo ’ s . A new Margo at t2 for as long as she is in that conscious experience , a new one at t3 when she cannot connect the previous experience with this new one , and so on and so forth . The slavery argument , as Buchannan characterises ( and rejects ; 1988 : 282 ) survives - even in his amended premise ( ii ), which Buchannan argues is most contentious , the individual who remains after the neurological damage really is a different person ( Ibid .); it is just the case that after each instance of substantial neurological damage ( as the disease worsens ) a new self comes into existence , with a weaker capacity for consciousness . To strengthen my rebuttal further ; let us accept Buchannan ’ s insistence that when rejecting the slavery argument that no self is left . This still does not answer the question as to why Margo ’ s directives at
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t1 , should enforce doctors to take some course of action at t2 . If there is no ‘ person ’, then it would still be the case that the advanced directive need not be adhered to in virtue of it being an advanced directive from Margo at t1 , as there is no ‘ self ’ that the directive is directed to . As Jaworska notes , just because a person has lost their rational and psychological capacities through dementia , ‘ does not imply that her advance directive is automatically authoritative ’ ( Jaworska , 1999 : 137 ). I agree with this point . Imagine in the Margo case that she was at a more advanced stage of dementia . Imagine too , that there was a potential cure that had been discovered whilst Margo had been demented , with a 50 % chance of success . What would we do then ? Do we adhere to Margo ’ s advanced directive and ignore any possible cure- in the strictest terms she directed at t1 that once she gets dementia , she should be helped with assisted suicide or not given life preserving medication for example ? Of course , most would say that we ought to give her the treatment in the hope that it works - that in all circumstances of a cure we should try to save that person . But if we were to accept that , then we are accepting that an advanced directive does not hold all of the power , or it does not hold all of the autonomy of the agent within in , that present contextual factors