Ulysses pact

A Ulysses pact or Ulysses contract is a freely made decision that is designed and intended to bind oneself in the future. The term is used in medicine, especially in reference to advance directives (also known as living wills), where there is some controversy over whether a decision made by a person in one state of health should be considered binding upon that person when he or she is in a markedly different, usually worse, state of health.

Origin of the name

The term refers to the pact that Ulysses (Greek name "Ὀδυσσεύς", Odysseus) made with his men as they approached the Sirens. Ulysses wanted to hear the Sirens' song although he knew that doing so would render him incapable of rational thought. He put wax in his men's ears so that they could not hear, and had them tie him to the mast so that he could not jump into the sea. He ordered them not to change course under any circumstances, and to keep their swords upon him and to attack him if he should break free of his bonds.

Upon hearing the Sirens' song, Ulysses was driven temporarily insane and struggled with all of his might to break free so that he might join the Sirens, which would have meant his death.

Psychiatric context

Psychiatric advance directives are sometimes referred to as Ulysses pacts or Ulysses contracts, where there is a legal agreement designed to override a present request from a legally competent patient in favor of a past request made by that patient. An example of when Ulysses contracts are invoked is when people with schizophrenia stop taking their medication at perceived remission times.

See also

• Advance health care directive
• Decision theory
• Greek mythology