Advance directives are instructions given by patients – or potential patients – specifying what actions ought to be taken for their health in the event that they are no longer capable to make decisions due to illness or incapacity. Over the last decades, there has been a rising tide in favour of advance directives: not only is the use of such directives recommended by most medical and advisory bodies, they are also gaining increasing legal recognition in many parts of the world. This book, however, takes as its point of departure one of the most commonly discussed medical-ethical arguments against granting advance directives moral force: the Objection from Personal Identity. The adherers of this objection basically asserts that when there is lacking psychological continuity between the person who formulated the advance directive and the later patient to whom it supposedly applies, this seriously threatens the directive’s moral authority. And, further, that this is so because lacking sufficient psychological continuity implies that the author of the advance directive is numerically distinct from the later patient. Although this argument has some initial appeal, most philosophers in the advance directives debate maintain that the Objection from Personal Identity fails, but suggest different reasons as to why. Whereas some argue that the objection has no force because it rests on faulty beliefs about personal identity, others argue that we ought to grant advance directives moral authority even if the author and the later patient are numerically distinct beings. This book investigates some of the most influential of these arguments and reaches the conclusion that the Objection from Personal Identity has more to it than is usually recognized in the medical-ethical debate. Lacking sufficient psychological continuity between author and later patient, it is concluded, does threaten the moral authority of the advance directive.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O objetivo dessa dissertação é realizar uma análise crítica da teoria que intenta explicar a natureza e a evidência da identidade pessoal através da memória. A primeira versão dessa teoria foi proposta por John Locke, a qual, devido à sua distinção entre pessoa, homem e substância, traçou os parâmetros fundamentais das discussões posteriores acerca da natureza da identidade pessoal. No entanto, essa proposta apresenta sérias fragilidades e inconsistências, apontadas de forma vigorosa principalmente por Joseph Butler e Thomas Reid. Posteriormente, autores como Parfit, Shoemaker e Grice realizaram reformulações na teoria lockeana com o objetivo de sanar suas inconsistências e assim responder à suas principais objeções, sem com isso perder seu aspecto central e característico, que é conceber a memória como elemento fundamental para o entendimento da identidade pessoal. Esse processo envolvendo a teoria lockeana, suas objeções e reformulações terá como resultado final a noção de identidade pessoal como continuidade psicológica não-ramificada. / The aim of this dissertation is to realize a critical analysis of the theory that intends to explain the nature and the evidence of personal identity through memory. The first version of this theory was proposed by John Locke, which due to its distinction between person, man and substance, sketched the fundamental parameters of the following discussions about the nature of personal identity. However, this proposal presents serious weakness and inconsistencies, indicated in a vigorous way principally by Joseph Butler and Thomas Reid. Later, writers as Parfit, Shoemaker and Grice implemented reformulations in the Lockean theory with the aim to reply its main objections, without losing its central and characteristic aspect, which is to conceive memory as a fundamental element for the understanding of personal identity. This process involving the Lockean theory, its objections and reformulations will have as final result the notion of personal identity as a non-branched psychological continuity.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O objetivo dessa dissertação é realizar uma análise crítica da teoria que intenta explicar a natureza e a evidência da identidade pessoal através da memória. A primeira versão dessa teoria foi proposta por John Locke, a qual, devido à sua distinção entre pessoa, homem e substância, traçou os parâmetros fundamentais das discussões posteriores acerca da natureza da identidade pessoal. No entanto, essa proposta apresenta sérias fragilidades e inconsistências, apontadas de forma vigorosa principalmente por Joseph Butler e Thomas Reid. Posteriormente, autores como Parfit, Shoemaker e Grice realizaram reformulações na teoria lockeana com o objetivo de sanar suas inconsistências e assim responder à suas principais objeções, sem com isso perder seu aspecto central e característico, que é conceber a memória como elemento fundamental para o entendimento da identidade pessoal. Esse processo envolvendo a teoria lockeana, suas objeções e reformulações terá como resultado final a noção de identidade pessoal como continuidade psicológica não-ramificada. / The aim of this dissertation is to realize a critical analysis of the theory that intends to explain the nature and the evidence of personal identity through memory. The first version of this theory was proposed by John Locke, which due to its distinction between person, man and substance, sketched the fundamental parameters of the following discussions about the nature of personal identity. However, this proposal presents serious weakness and inconsistencies, indicated in a vigorous way principally by Joseph Butler and Thomas Reid. Later, writers as Parfit, Shoemaker and Grice implemented reformulations in the Lockean theory with the aim to reply its main objections, without losing its central and characteristic aspect, which is to conceive memory as a fundamental element for the understanding of personal identity. This process involving the Lockean theory, its objections and reformulations will have as final result the notion of personal identity as a non-branched psychological continuity.

In this thesis, I argue that the interdependence between personal identity and practical concerns is overstated. In paradigmatic places where philosophers and common sense suggest that personal identity constrains how we should reason and care, or vice versa, the two spheres are in fact neutral to each other. I defend this claim by considering four specific cases. First, a rough characterization of the distinction between the complex and the simple view is that the former takes personal identity to consist in other relations, whereas the latter does not. I argue that the extreme claim according to which the complex view fails to give reasons for future-directed concern can be resisted. We maintain forward-looking attitudes and projects not because someone will be us, but because we relate to future selves in other, more important ways. Second, I argue that intuitions in a range of popular imaginary cases are contaminated by practical concerns whose relevance for personal identity is far from straightforward. Third, I argue that on a closer look, the complex versus simple distinction is confused. It thus cannot be what grounds differences in judgements on what matters. Debates about personal identity should be framed in terms of better understood notions. Finally, I argue that it is not a constraint on rational transformative choice that decision-maker and transforming individual are identical. Moreover, whether we are deciding for ourselves or for others - the importance of informed consent for transformative treatments is not diminished by the decision-maker's failure to projectively imagine the outcomes.