example works on the assumption that because the outer ‘ shell ’ is the same and preserved , then there is some temporal continuity through this constitution relation . However , brain structure alters the organism as well as the person , and so the relation breaks down . Just because the organism on the outside looks like it has temporally survived past the person , does not mean that it has .
Autonomy in the face of differing persons
This line of argument has led us to reject the advanced directive made by Margo . However , we have not solved the problem of what we do for Margo in this scenario . Whilst we do not follow the advanced directives made previously , we must find a way of deciding whether we respect Margo ’ s current wishes . Essentially , this section will ask the same question as Jaworska - ‘ at what point in the course of dementia are the attributes essential to agency lost ?’ ( Jaworska , 1999 : 109 ). To be clear , just because Margot at t1 has lost her agency , Margot at t2 could possibly have agency ; focusing on Margo in the present moment , what is it that guides our ethical reasoning ? Intuitively one would say that we ought to respect her contemporaneous interest whilst she is still an agent ; one can think and make some choices .
Owen Morris
SOTA Anthology 19 / 20
For example , we have no harm in allowing Margo to eat her favourite type of sandwich- she has the agency to make this choice . One thing that I have not focused on is Dworkin ’ s differentiation between experiential and critical interests as I have not required it for my general argument . However , it still is an important distinction to note . As summarised by Jaworska , Dworkin holds that whilst demented patients can have experiential interests ( about the quality of the person ’ s experience ), they cannot have critical interests ( holding strong beliefs and values regardless of the experiential situation ) ( Jaworska , 1999:1 10 ). It is because of this that Dworkin attempted to bridge the gap in the Margo case by claiming since she has no critical interests apart from the advanced directive before the disease took over , we should adhere to that .
Whilst we need not respect the advanced directive in virtue of it coming from a different self , whether we adhere to demented Margo ’ s wishes is another matter . Does she have sufficient autonomy to make decisions so we should do as she says like we would respect a rational being ’ s autonomy ? Does she have critical as well as experiential interests ? Jaworska reframes Dworkin ’ s thinking to argue that we can take Margo ’ s contemporaneous wishes