• J Med Philos · Aug 2005

    Review

    Protecting autonomy as authenticity using Ulysses contracts.

    • Theo van Willigenburg and Patrick Delaere.
    • Erasmus University Rotterdam, Oudegracht 291, 3511 PA Rotterdam, The Netherlands. vanwilligenburg@kantacademy.nl
    • J Med Philos. 2005 Aug 1; 30 (4): 395-409.

    AbstractPre-commitment directives or Ulysses contracts are often defended as instruments that may strengthen the autonomous self-control of episodically disordered psychiatric patients. Autonomy is understood in this context in terms of sovereignty ("governing" or "managing" oneself). After critically analyzing this idea of autonomy in the context of various forms of self-commitment and pre-commitment, we argue that what is at stake in using Ulysses contracts in psychiatry is not autonomy as sovereignty, but autonomy as authenticity. Pre-commitment directives do not function to protect autonomous self-control. They serve in upholding the guidance that is provided by one's deepest identity conferring concerns. We elucidate this concept of autonomy as authenticity, by showing how Ulysses contracts protect the possibility of being "a self."

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