Should the Dead Decide for the Living? The Moral Authority of Advance Directives and Posthumous Interests

Accepting a reductionist view of personal identity threatens the moral authority of advance directives—a challenge often referred to as the personal identity problem of advance directives. According to this view, when cognitive deterioration reaches the point where advance directives would typically come into play the author of the directive will have ceased to exist in the relevant sense. As a result, the advance directive can no longer be said to express that person’s wishes but only those of a former, numerically different self, rendering the directive without purpose. Building on the principle that like cases should be treated alike , this paper argues that the implications of the personal identity problem extend beyond advance directives. In particular, it examines how a consistent application of the argument calls into question common assumptions about posthumous bodily rights—especially the widely held view that individuals hold fundamental rights over their body after death, including decisions about organ donation.