These studies are now increasingly familiar to students of the shared decision-making model, and perhaps they should come as no surprise. First, there is a clear fallacy to what Harry Frankfurt referred to as the “sloganistic desire to cram everything that we think is good into the concept of freedom.”18 Instead, people share many other values, including the comfort and support that may come with assistance in making tough choices. Life can be worthy and satisfying without going through it constantly constructing plans, scrutinizing them, and making considered, rational choices.3 Second, patients, especially the critically ill, often lack realistic abilities to foster positive liberties, even if their physicians deem them as having the “capacity”19 to do so. Because the choices are often complex, the metaphors and analogies that experienced clinicians often draw may remain inaccessible (or, on the other hand, be overly simplistic). Third, although many patients value the development and exercise of autonomy in other areas of their lives (eg, lifestyle, career, relationships, religion, etc.), it is understandable that in the domain of health care people may prefer not to be left to make decisions themselves. Such reluctance may stem from the fact that these decisions have to be made at a time when patients are most vulnerable, the decisions may involve options about which the decision maker has very little experience or knowledge, and determining which of several options best promotes one’s own interests often requires expert judgment. Finally, the few who do wish to exercise positive autonomy over their health-care decisions can certainly make such preferences clear to their providers, who should, in turn, respect these preferences to all reasonable extents.