The ethical principle of respect for the autonomy of the patient has acquired an important place in psychiatric care. Within the dominant rights discourse this autonomy principle is onesidedly filled in from a negative concept of liberty: the protection of the individual from unwanted interference. Opposite to this interpretation of the principle of autonomy a number of alternative views are elaborated. Characteristic for these approaches is that they give a broader and richer interpretation of the autonomy principle. The implications of these different perspectives for clinical practice are illustrated on the basis of a case.