Efforts to address the “paradox of autonomy in long-term care” attempt to salvage an ethic of autonomy by redefining the central concept, and then applying it to the long-term care environment. Such attempts are critiqued, and an alternative ethic of dignity for long-term care is developed. Autonomy, it is argued, is crucial to certain aspects of dignity, but should not be confused with the whole of it. Indeed, long after the capacity for autonomy has diminished or vanished, basic dignity continues to exert normative force.