Abstract
While digital advance directives, such as the P4 system, have been presented as promising alternatives to surrogate decision-making, these systems have also faced criticism for being potentially misguided and even unethical. In this presentation, I critically examine two objections to the dominant emphasis on the loss of autonomous choice, with the aim of re-evaluating the philosophical foundations of digital advance directives through the lens of family ethics. First, I analyse how the debate surrounding digital advance directives is misleading in its focus on proxy decision-making as merely a matter of reproducing preferences. This narrow conception of autonomy overlooks the fact that such decisions often involve shared agency and familial responsibility. Second, I argue that the current literature largely ignores issues of social and epistemic injustice—concerns that cannot be dismissed in the ethical evaluation of these technologies. The presentation concludes by addressing a potential objection: that incorporating a family ethics perspective might reinforce irrational preferences for maintaining the status quo.

This will be a hybrid meeting in the Richard Doll Building Lecture Theatre and on Zoom (medsci.zoom.us/j/96943361305)