Abstract

This dissertation explores and defends Ulysses contracts. Chapter 1 begins with an analysis of the original passages in Homer from which the Ulysses contract is derived. This analysis justifies the original Ulysses contract as it protected the autonomy and future directed plans of Ulysses. This analysis also demonstrates the differences between the original Ulysses contract and modern Ulysses contracts that require further justification. ;Chapter 2 turns to the recent history of Ulysses contracts. The original proposal for their use in the treatment of mental illness, as well as objections that invoking such contracts is unjustifiably paternalistic, are discussed. This chapter shows that to defend Ulysses contracts, an analysis of the plans, desires, beliefs, and associated reasoning of the patient is needed. ;To this end, Chapter 3 analyzes the dismissal of Ulysses contracts as unjustifiably paternalistic and show that the dismissal depended upon analyzing Ulysses contracts through a desire-belief model of practical reasoning. The desire-belief model is then challenged and its flaws relevant to the Ulysses contract debate are shown. An alternative model of practical reason for the evaluation of Ulysses contracts, the planning theory of practical reason, is then proposed. The planning theory is used to argue that it is rational for some patients to engage in Ulysses contracts. Furthermore, if it is rational for some patients to engage in Ulysses contracts, the enforcement of such contracts is not paternalistic but is merely respectful of the patient's wishes. In this chapter practical issues are also addressed, such as suggestions for specific refinements to be made to Ulysses contracts, how Ulysses contracts should be enforced and who should be involved, and legal aspects pertaining to current civil commitments laws in the United States. ;Finally, Chapter 4 explores other possible applications for Ulysses contracts. These applications include quitting smoking, following a painful yet beneficial postoperative course of physical therapy, and following a posttransplant treatment regimen. This discussion also demonstrates the limits of Ulysses contracts' applicability.