This study seeks to comparatively examine how autonomy is evaluated by a sample of nursing staff in both Sweden and Florida, USA. In both cultures support for patient autonomy was generally greater from an individual point of view than from the anticipated institutional perspective. Comparisons between the cultures revealed that individual staff members in the Swedish nursing homes generally gave higher priority to patient preference than did their American counterparts. On the other hand, support for patient preference was generally greater in the American nursing homes in regard to institutionally anticipated decision. There were statistically significant mean value differences between Swedish nursing staff's personal opinion and anticipated institutional decisions in five of six case studies. Nursing staff's personal opinion showed a stronger support for patient's preferences. There was a statistically significant mean value difference between American nursing staffs' personal opinion and anticipated institutional decisions in only one of the six case studies. In spite of cultural differences the reported results to some degree reflect a common value-system regarding both the anticipated institutional perspective and nursing staffs' personal opinion.