Traditional views of autonomy, defined as self-direction, have emphasized noninterference. This view of autonomy assumes that individuals have the capacity and the resources to make the choices necessary to pursue plans and projects and that society has only a minimal stake in what individuals choose. One result of giving ethical priority to such a concept of autonomy has been for bioethics to focus on the "minimization of harm" rather the "maximization of good" (Fox and Swazey, 1984). To maximize good would require explicit attention, for example, to the preconditions that permit the exercise of choice. Instead of viewing autonomy as unfettered decisionmaking by an isolated individual, Agich (1993) develops a view of autonomy that takes seriously the social context of moral life and the specific conditions that support or negate the possibilities for autonomy. According to Agich, to act autonomously is "to strive and to experience the world in a precarious dialectic of habit and choice, necessity and reason." This chapter discusses how this perspective on autonomy affects ethical thinking about the autonomy of elderly persons dependent on and often mistreated by others. Constraints on pursuing the "best" life choices for disabled elderly persons are identified, and suggestions are offered for how professionals who serve the elderly can act ethically in serving the ends of autonomy within the constraints of a particular situation. 26 references