ABSTRACT The Euthyphro dilemma highlights that accounts of moral value which are dependent on the decisions of agents either result in arbitrary values arising from agent's decisions, or accept external reasons to morally justify the value, making the agent's decisions unnecessary for explaining the resulting value. This highlights an explanatory problem when the autonomous choices of patients form the basis of a moral justification for assisted dying. Providing any other moral reason in support of a request for assisted dying would undermine any moral justification for the request based solely upon the autonomy of the patient. When assisted dying is justified solely by patient's autonomous requests, patients requesting assisted dying are not treated as moral agents, because moral agents act for reasons. This does not mean that autonomy does not have a vital role in morality, as a safeguard against force, deceit or coercion being used to override the agency of patients. Autonomy is the necessary starting point of the development of virtue and the growth of human agency, but not its goal. In virtue ethics, patient's autonomous decisions, such as when requesting assistance to die, can be either virtuous or vicious, and so moral evaluation of the reasons for their choice is necessary to decide whether or not they can be shared by clinicians.