Those who advocate advance care planning largely do so based on ideas of life as a whole. They hold that our identity is based on critical values and interests which form the skeleton of our life narrative and that we have a vested interest in maintaining this narrative, even when we lose the capacity of being competent life narrators. Being a life narrator on their account is not simply someone who tells how one's life goes, but someone who creates the story, which extends into the future. The significance of directing the "last chapter" lies in giving expression to a unified whole with particular emphasis on having a say in what should be the end to this whole. We should therefore have a right to maintain our narrative beyond mental incapacity by means of advance care planning.
My paper examines the tight connection between ideas of identity, autonomy and life holism and how the coherent interplay of these concepts is important for the ethical and practical framework of advance care planning. I will briefly start by defending the view that a narrative identity account is the best identity account in overcoming ethical problems associated with the "identity problem" of advance care planning. I will then discuss, why the successful solution to this problem is nonetheless insufficient to overcome significant problems associated with advance care planning. My argument is based on the insight that a conceptual frame work for advance care planning which is based on narrative identity forces us to adopt a corresponding idea of narrative autonomy and that such an account of autonomy is inconsistent with (and undesirable for) our current medico-legal practice.