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Significance The debate over whether people ought to be guided paternalistically or given full decisional autonomy has been raging for centuries. However, in many Western societies, autonomy has become the gold standard. The US medical system, in particular, has increasingly prioritized patient autonomy. The present research examines the important question of how patients and advisees broadly react to full decisional autonomy. We find that advisees making difficult decisions prefer paternalism to autonomy, but doctors do not anticipate this preference. We document this preference within medicine and within a range of other contexts characterized by adviser–advisee asymmetries in expertise. Our results suggest that advisees facing difficult decisions do not perceive autonomy as the gold standard.

Decisional autonomy undermines advisees’ judgments of experts in medicine and in life