After receiving numerous queries about a paperback edition for classroom and other use, I undertook revisions to Autonomy and Long-Term Care, the predecessor of this edition, with the intention of bringing my ideas about autonomy in old age to a larger audience. Oxford University Press, publisher of the original book, ultimately decided against a second edition. Fortunately, an arrangement with Cambridge University Press was worked out that permitted the publication of this revised edition. Dr Richard Barling, Medical Publishing Director of Cambridge University Press, has been incredibly supportive of this project as discussions with OUP proceeded. Jeffrey House and Edith Barry of OUP were also very helpful throughout these discussions and I am very grateful for their longstanding good will.

Work on this edition was supported with research help provided through the F.J. O'Neill Chair in Clinical Bioethics. The longstanding support of Nancy O'Neill, Hugh O'Neill, and the F.J. O'Neill Charitable Foundation for Bioethics at the Cleveland Clinic Foundation has been truly remarkable. Their continued support during my tenure in the O'Neill Chair has been outstanding and gratefully appreciated.

The first edition of this book was dedicated to my mother-in-law and father-in-law. My father-in-law had been diagnosed with Alzheimer's disease and required institutional care, so their view of the problems discussed therein was far more significantly ‘inside’ than my own. Several years ago, my own mother also developed memory loss and confusion that eventually necessitated her moving into an assisted-living center, where she resided until her death.