Advance Directives and Research Advance Directives

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 ABSTRACT
 This paper explores a way to ensure person’s autonomy and legacy are preserved during the experience of dementia due Alzheimer’s disease. Due profound effect disease has memory, “person lifetime” (the past experiences their future aspirations prior progression) becomes seemingly disconnected from moment,” or person experiencing memory loss. Thus, directives important recognize maintain continuity person. Yet, “legacy,” based values philosophy, can serve as bridge between those two identities. Ultimately, people with significant loss unable secure own diminishing ability make autonomous decisions progresses. A legal system that codifies create requirement honor ADs research advance (RADs) best lifetime, thus legacy, disease.
 INTRODUCTION
 At present, there is no effective treatment cure for disease’s cognitive decline ensuing dementia. While definitive diagnosis confirmed only after death via brain autopsy, diagnosed symptoms scans.[1] Over course an eight-to-twelve-year post-diagnosis period, progressively lose functions in irreversible pattern.[2] Because remains incurable despite scientific into its causes, biological qualities,[3] symptoms, many may wish document care choices while they have capacity do so. Those early-stage mild impairment wanting determine path private public life’s agenda must tools needed sound plans future.
 l. Preserving Legacy: The Benefits Advance Directives People Disease
 part patient will persist future, even death. Autonomy be increased permitting patients wishes impairment. Whether others’ memories personality traits something concrete like business, named building, charity, cookie recipe, lifetime remembered. Many not want remembered end life, cognitively impaired moment. I argue oneself defined one’s his her most personal, philosophy values. When third-party caregivers healthcare workers seek impose views interests moment, disrespecting interests. Having AD respect help all stakeholders moral legitimacy.
 preservation maximized focusing both present life experiences. Significant interrupts usual relationship who understand but near-complete short- long-term loss.[4] Reconciling these “personhoods” one formal process serves assessing various perspectives providing decision-making framework stakeholders. assert deserves equal more weight than third party when moment lacks decision. argument compatible Samuel Dale’s “precedent morally authorizes renders medically incompetent because it respects dignity persons, merely pleasure-seeking creatures.”[5] Dale relies Dworkin’s view critical should carry “experiential interests.”[6] pursuit gives meaning human encoded represent whole person.[7]
 Nevertheless, value enjoy happiness. Treatment focuses comfort happiness driver patient’s interests, attending needs balanced if conflicts, damage legacy. avoid pain arguably achieve some happiness, simultaneously relying, insofar still possible, obtain peace contentment.[8]
 Respecting consistent strong individualism inherent US. rule law attempts maximize theoretically individual rights.[9] In US other liberal democracies, recognizing power inalienable rights involves securing right decisions. rights, situations where absolute laws limit full effect. Some statutory regulatory restrictions legally difficult ADs, especially nutrition hydration directives.[10] Arguably poorly considered approach; notably, at least scholar, Corinna Porteri, argues “statutes disregard invalidate discriminatory against lived.”[11]
 ll. Research necessary better treat requires engaging research. major bioethical question immediately arises: how we informed consent weigh different options risks/rewards properly? could allow advanced participation place limits consent.[12] able express desires early stages before diagnosis. desire join clinical trials. National Bioethics Advisory Committee recommended RADs,[13] which studies medicine would benefit them, possibly larger potential person.[14] Porteri asserts RADs include type degree risk, impossible predict types anticipated side effects studies.[15] take precedence further offers hope legacies others.
 Still, cases societal interest protecting takes precedence. Societal preserving avoiding suffering. It safeguard limiting low-risk requiring additional proxy caregiver.
 appealing guide decisions, ADs; unique appeal specific RAD certainty permanently valuing medical writing over uncertainty facing tenuous grounds, philosophical solutions.
 arises regarding change mind threshold established How known changed minds given current circumstances often-lengthy progress disease? If wanted withdraw expressed unwillingness engage research, deprived withdraw. By occurs, certainly decide about themselves, input family, friends, doctors. Early permits time alter develop progression disease, honored. proof govern lost.[16] Bodily integrity, belief, respected once lost.
 lll. Recommendations
 Capacity task-specific; therefore, determining implemented testing.[17] turns interpreting lifetime’s applied For example, dying battle quite memorial outcome compared vegetative state fed artificial through feeding tube. Establishing desired allows choose remembered.[18] 
 One problem our deviates substantially state. Patient Self Determination Act does prescribe address loss.[19] Therefore assumed laws. federal supports acknowledgment preferable. you live die fundamental choice depend lives.
 Fortunately, parties align cases, lifetime. To greater proportion patients, states RADs. Currently, offer unpredictable protection, move Unpredictable factors judicial discretion, shifts thinking within body politic, odds Judicial discretion limited invalidating were fraud, undue influence, incapacity inception.
 Administrative personnel authority redefine reaches stage longer capacity. dispute resolution mechanisms well persons involved care. declaring yet acknowledging differences loss, Giovanni Boniolo concludes, “We them long capable choosing deciding. Then, this vanished, continue respecting also made.”[20] absolutely correct; creating until not. sharper approach base point capability markers. made decisions.
 CONCLUSION
 Permitting unfaithful surrogate administrator reinterpret “slippery slope,” compromising writing. opportunities risk dementia, preserve use significantly memory-impaired binding documents avoids quagmire courts, doctors, surrogates, caregivers. impairment, evolving moment.
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 [19] HR 5835 Omnibus Budget Reconciliation 1990, Title IV, Section 4206. Congress.
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