Frankfurt's hierarchical mesh theory establishes that an agent acts freely when their effective will aligns with higher-order volitions, regardless of the causal history producing those volitions.
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Higher-order volitions(what your commitments must align with)
Your deeper desires about what you *want to want*—like wanting to want to exercise, or wanting to want to be patient. It's one level up from just having an immediate desire.
agent(Economics terminology applied to medical ethics)
The party in a principal-agent relationship who is instructed to produce the good or service on the principal's behalf — in the medical context, the doctor
effective will(in Frankfurt's philosophy of agency)
Your actual desires and intentions that drive what you do—what you truly want to happen, as opposed to conflicting desires you might also have.