 This general framework opens up a number of ethical issues. I shall set aside here a foundational issue that is a subject of its own encyclopedia article: What are the criteria for  decision-making capacity?  These must be specified before we can establish, on any given occasion, whether there would be any need at all for decision-making by a third party (with the aid of an advance directive or not). Assuming we have settled, using the appropriate criteria, that surrogate decision-making is indeed called for, the following main issues arise: