The presentation will deal with the situation of who is the representative of a person with limited autonomy, and who can decide on the care provided to the patient. Autonomy is a key ethical and legal principle in health care provision. We can define it as a manifestation of the patient legal and mental capacity to understand information related to the health care provision, and then make an informed decision in the form of informed consent. There is a presumption that an adult patient has the full capacity to decide on health care provision. But autonomy is not absolute and therefore it is limited. Not only minors have limited autonomy, but also adult persons for whom the court defined the extent to which it has limited a person's ability to act independently legally. If a patient cannot consent or refuse health care due to lack of capacity, then the decision is made by the patient´s legal representative.These situations will present with specific examples and will be demonstrated by references to the court decisions. These reflect not only the legal regulations but also ethical principles. The presentation will provide a practical context without dwelling on legal minutia. And will allow the audience to compare the practical examples and cases with their own experience from their countries of origin.