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This article discusses medical and social care for hospitalized or institutionalized elderly people. From the results of qualitative studies and cases in clinical ethics about medical decision-making in geriatrics, prevailing arguments in medical decision-making are the following: the patients’ medical best interests—in terms of recovery or better quality of life; the best interests of their relatives; logistics, institutional or administrative issues; equal access to care; and health professionals’ subjective representations of what elderly people need. These arguments fall within bioethical principles of beneficence/non-maleficence and justice. The principle of respect for patient autonomy is often discredited. In other words, patients’ “wishes” seem to weigh less in decision-making than other arguments. Although the autonomy of elderly people may be less accessible than in younger patients, it can be broken down and detailed. The aim of the paper is to show that arguments relating to autonomy can enrich the ethical discussion before a medical decision is made, ensuring that this decision is more respectful of the elderly patient.