Advance consent, critical interests and dementia research.

Although advance directives have become a familiar instrument within the context of treatment, there has been minimal support for their expansion into the context of research. In this paper I argue that the principle of precedent autonomy that grants a competent person the right to refuse life-sustaining treatment when later incompetent, also grants a competent person the right to consent to research that is greater than minimal risk. An examination of the principle of precedent autonomy reveals that a future-binding research decision is within the scope of a competent person's critical interests, if the decision is consistent with what the person believes gives her life intrinsic value. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.