Who am I? Self-Fulfilment and the Persisting Evolving Self: Decision-Making and Ireland’s Assisted Decision-Making (Capacity) Act 2015

The article proposes a framework for understanding personhood in the context of cognitive decline, called the persisting evolving self, emphasising selfhood and continuity. It uses the new Assisted Decision-Making (Capacity) Act 2015 (ADMCA) in Ireland as a vehicle through which this way of conceptualising the self, and the rights assigned to it, can be assessed. The case study of ‘Martha’, who has dementia, is used to highlight the development of the law in Ireland from the Ward of Court system to the support-based tiered mechanisms inherent in the Act. It contends that the ADMCA involves a powerful and empowering paradigm shift from best interests standards to a rights-based approach. This new approach is based on the concepts of autonomy, support and will and preferences. The article evaluates the ADMCA through the vista of Alan Gewirth’s Principle of Generic Consistency (PGC). Furthermore, the practical realities of the Act’s tiered support mechanisms are balanced with people’s lived experiences of diminishing capacities, as understood within the PGC’s concept of agency. The persisting evolving self builds upon and reconceptualises the Gewirthian concept of ‘self-fulfilment’.