Advance Directives and Transformative Experience: Resilience in the Face of Change

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Sturm College of Law


Transformative experience framework, Walsh, Dworkin, Dementia


Walsh valuably deploys L.A. Paul’s “transformative experience” framework (2016) to challenge Ronald Dworkin’s defense of following advance directives prepared in advance of dementia (1994). In this commentary, I critique three aspects of Walsh’s paper: (1) the ambiguity of its initial thesis, (2) its views about the ethics and legality of clinical practice, and (3) its interpretation and application of Dworkin’s and Paul’s views. I also consider what Walsh’s proposal would mean for people facing the prospect of dementia. I conclude that our reasons to honor many advance directives survive the move to a transformative experience framework.