Four studies of patient preferences for participation in medical decision making presented a modified Autonomy Preference Index (Ende, Kazis, Ash, & Moskowitz, 1989; D. Smith, Garko, Bennett, Irwin, & Schofield, 1994) to adults in Hong Kong and 3 mainland Chinese cities, and to students in Australia, the United States, Hong Kong, and mainland China. The results showed a consistent preference for participation in medical decision making in all groups regardless of nationality or cultural differences. Australians and Hong Kong and U.S. students preferred patient decision making to delegating decisions to doctors, but all others preferred doctor decision making to deciding alone. The results show that patients across cultures have a strong preference for a mutually participative relationship with doctors.