Advance directives derive their authority from autonomy, but autonomy norms require that the directive-issuer and the person bound by it share sufficient psychological unity to constitute a single deliberating agent.
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Psychological unity(personal identity and medical ethics)
A continuous sense of being the same person over time—having the same memories, values, personality, and way of thinking that connect your past self to your present self.
autonomy(Used to ground worker rights to self-governance in the workplace)