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Abstract：
Advance directives are intended to extend patient autonomy by enabling patients to prospectively direct the care of their future incapacitated selves. There has been much discussion about issues such as whether the future incompetent self is identical to the agent who issues the advance directive or whether advance directives can legitimately secure patient autonomy. However, there is another important question to ask: to what extent and in what conditions is it ethically appropriate for one to limit the liberty or agency of one\'s future incompetent self by issuing an advance directive? In this paper, I use a virtue-ethical approach to explore this question, focusing on the case of an advance directive for the future self with moderate dementia. First, I examine virtuous attitudes with regard to autonomy and argue that one can manifest vices or ethically undesirable character traits in trying to intervene in the future self\'s life. In particular, I argue that this case can manifest vices such as disdainfulness, intellectual arrogance, and self-dictatorship, which is the vice of trying to control one\'s life to an excessive degree, and that a self-dictator fails to give due moral consideration to the future self\'s liberty or agency. I then introduce the Daoist idea of wu-wei, which recommends embracement of what happens in one\'s life, as one of the possible remedies for the overemphasis on the value of autonomy and control.
摘要：
预先指令旨在通过使患者能够前瞻性地指导对未来无行为能力的自我的照顾来扩大患者的自主权。关于诸如未来无能的自我是否与发布预先指示的代理人相同，或者预先指示是否可以合法地确保患者的自主权等问题，已经进行了很多讨论。然而,还有另一个重要的问题要问：在什么程度上和在什么条件下，它是道德上适当的限制自由或代理一个人的未来不称职的自我发布预先指令？我用美德伦理的方法来探索这个问题，专注于对未来患有中度痴呆症的自我的预先指示。首先,我研究了关于自主性的良性态度，并认为在试图干预未来自我的生活时，人们可以表现出恶习或道德上不受欢迎的性格特征。特别是,我认为这种情况可能会表现出诸如轻蔑之类的恶习，智力上的傲慢，和自我独裁,这是试图过度控制自己生活的恶习，而一个自我独裁者没有给予适当的道德考虑未来自我的自由或代理。然后我介绍吴卫的道教思想，建议拥抱生活中发生的事情，作为过度强调自治和控制价值的可能补救措施之一。
