When patients are unable to express their wishes and do not have surrogates or advance directives, which and whose values should inform decision making for them? We discuss ethical complexities of caring for unrepresented patients.

A guardian’s request to sterilize a woman with intellectual disabilities is not ethically justifiable unless the woman assents and it is to her benefit.

Women who are pregnant might not treat their mental illnesses because they overestimate risks of medication and underestimate risks of leaving their illness untreated.

Shared decision making honors patient autonomy, particularly for preference-sensitive care decisions and even when patients have impaired decision-making capacity.

Shared decision making is practically difficult to implement in mental health practice but remains an ethical ideal for motivating therapeutic capacity.

Dr Laura Guidry-Grimes helps us consider whether and which decisions can be shared with people experiencing mental illnesses.

Interviews, photographs, drawings, and paintings explore Suzanne’s lived experience of cancer and American Indian cancer inequity.

Dr Sean C. McConnell provides an introduction to gene editing, and Scott J. Schweikart discusses what prudent governance requires.

Transplant physicians must respect indecisive patients’ autonomy while continuing to educate them during their progress towards transplantation.

CHWs’ work underscores need for clinicians and organizations to respond to deeply entrenched, long-standing patterns of oppression in ways that draw upon lived experience.