The self-determination of patients is rightly upheld in liberal and individualized societies. However, the freedom of action of individuals in a highly complex world structured by scientific and technical rationalities only increases to the extent that personal and systemic trust is enabled. For with the possibilities of modern medicine come also the vulnerability and uncertainty of the actors. The contributions in this volume from the fields of philosophy, medical law, theology, medical ethics, and medicine examine the extent to which interpersonal trust or systemic trust is related to practices of self-determination. Special attention is given to institutions such as hospitals and collective actors like families or patient groups.