Consent to Ulysses Contracts

You can - like Ulysses - consent to an act that will be performed in the future, even though at that future point you may no longer wish for it to be carried out. In such cases, consent is given to take effect at a later time when the consent-giver anticipates that they will no longer want to be treated as she currently prefers. This is known as “consent to Ulysses contracts”, which plays an important role in psychiatric care. For instance, an agent consents in advance to forced treatment at a later time t₂. However, when that time arrives, she no longer wishes to undergo the treatment and revokes her prior consent. Does this revocation render the prior consent morally ineffective? And does it thereby make treatment against the agent's will no longer permissible? One might argue that forced treatment at time t₂ could be justified on paternalistic grounds. However, the question I address is not whether forced treatment may be justified on such grounds. Rather, the issue is whether forced treatment at t₂ is permissible on the basis that the agent's prior consent remains valid.

I defend the competence model, which holds that prior consent remains valid if and only if the agent is incompetent to withdraw it. I argue that this condition is met when the following two criteria are satisfied: (a) the reasons the agent had for giving prior consent still apply, and (b) the agent is unable to respond to those reasons. It has been argued that the competence model does not impose strict enough conditions to justify treating prior consent as binding in Ulysses contract cases. However, I will argue that this concern is unfounded.