Should we pay attention to then-self vs now-self distinction


Problem

Do you agree or disagree with London and Kestigian's argument that if, due to illness or incapacity, patients' interests change then the link between respect for autonomy and fidelity to patent welfare is severed? Should we pay attention to the "then-self versus now-self" distinction in making our assessments or should we treat advance directives as a sort of Ulysses contract (i.e., a freely made decision that is intended to be binding in the future)?

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