When dementia severs that psychological continuity, the advance directive functions not as self-determination but as one person's imposition on a numerically or practically distinct other, which standard liberal autonomy theory does not license.

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Dementia(as a test case for personal identity theories): A serious illness that damages a person's memory and thinking skills, often making them forget who they are and who others are.
Liberal autonomy theory(as a standard ethical approach to individual rights): A philosophical framework that says respecting people means letting them make free choices about their own lives without interference, as long as they don't harm others.
advance directive(End-of-life medical ethics and personal identity): A legal or medical document signed by a competent person stipulating what medical treatments should or should not be applied to that person in a future state of incompetence.
numerically distinct(Used to characterize the parts of the Form that must exist separately in each participant): Being distinct in the sense of being different individual tokens, not merely different in kind or quality.

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