This article concerns the issue of how an ethic of care perspective may contribute to both normative theory and mental health care policy discussions on so called Ulysses arrangements, a special type of advance directives in psychiatry. The debate on Ulysses arrangements has predominantly been waged in terms of autonomy conceived of as the right to non-intervention. On the basis of our empirical investigations into the experiences of persons directly involved with Ulysses arrangements, we argue that a care ethics perspective may broaden and deepen the debate on Ulysses arrangements, by introducing additional concepts, such as vulnerability, responsibility and mutuality, and by refining familiar concepts, such as autonomy.
- medical ethics
- ethics of care
- advance directives
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Funding: The research project described has been funded by The Netherlands Organisation for Scientific Research (NWO) from 1999 to 2002 with no further involvement.
Competing interests: None.
↵iWe prefer the term Ulysses “arrangement” to the terms “contract” or “statement” that may be found as well. The term “contract” may put too much emphasis on juridical aspects; “statement” has the connotation of a one-sided declaration, whereas the term “arrangement” suggests that both in the formulation and in the application others are involved. This is one reason why Ulysses arrangements may be considered a special type of advance directive. Another special characteristic is that Ulysses arrangements concern temporary situations that patients have experienced earlier.