Patient autonomy has been a frequently discussed issue since the 1960s. Nearly all bioethical works stress the necessity of respect for the patient’s autonomy. For many years now, a conscious consent of the patient to medical treatment has been fundamental for medical ethics. The patient’s acceptance of treatment is a confirmation of their autonomy in this area. From the moment autonomy became a fundamental issue in the doctor-patient relationship, the concept has been given numerous definitions. This article provides a number of suggestions of how to understand the concept of autonomy. However, there is a vital elementary question: does autonomy apply to all patients to the same degree? Are patients on psychiatric wards, patients with alcohol or drug addiction and patients serving a jail sentence entitled to the same extent of autonomy as others? Regardless of whether they are capable of undertaking, with the help of their doctor, a course of medical treatment, or whether they are capable of making conscious decisions relating to their health and needs. Where are the limits of their autonomy? To summarize, the article argues that a paternalistic approach of doctors to their patients is dangerous and that there is a need to reflect on the scope of autonomy of patients on psychiatric wards.