  It is, however, important to notice that the capacity for autonomy, as interpreted by Dworkin, comprises two distinct abilities: (1) the ability to espouse a “genuine preference or character or conviction or a sense of self” — what may be called, for short, the ability to value — and (2) the ability to act out of one's sense of conviction, that is, the ability to enact one's values in the complex circumstances of the real world. In many brain disorders these two abilities come apart. For example, a patient in the middle stages of Alzheimer's disease may retain genuine values — she may hold on to family ties or to the conviction that helping others is good­ — and yet, due to a rapid deterioration of short-term memory, she may be perpetually confused and unable to figure out how to enact these values in the concrete circumstances of her life. The set of values such a patient retains would typically be a curtailment of the original set, introducing the potential for conflict between the interests of the earlier and current self. For example, earlier, the person may have valued independence above all else, and so was adamantly against having her life prolonged if she developed Alzheimer's disease. Now, in moderate stages of Alzheimer's, she has lost her commitment to independence, but still values emotional connections to family members, and thus has a strong interest in continuing to live. On Dworkin's approach to decisions on this individual's behalf, her current interests are not allowed to override her earlier interests because she has lost her standing as an autonomous agent: due to her confusion, she is unable to act on her commitment to the family ties or on any other values — she is unable to run her life by her own lights, that is, to govern herself. However, on an alternative view (Jaworska 1999), what matters most for autonomy and personhood are the starting points of autonomous decision-making: the genuine values that the person still holds. So long as an individual is capable of valuing, she remains a being of a morally privileged type, and interests stemming from her values have the authority to dictate how the individual ought to be treated. The person need not be able to enact her values on her own — it is part of the surrogate's role to assist with this task. In short, on this alternative view, the capacity to value marks the morally crucial threshold above which the current interests of a formerly competent individual remain authoritative for the surrogate's decisions and the conflicting interests of the earlier self can be set aside.