RT Journal Article SR Electronic T1 The Patient preference predictor and the objection from higher-order preferences JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP medethics-2022-108427 DO 10.1136/jme-2022-108427 A1 Jakob Thrane Mainz YR 2022 UL http://jme.bmj.com/content/early/2022/07/01/jme-2022-108427.abstract AB Recently, Jardas et al have convincingly defended the patient preference predictor (PPP) against a range of autonomy-based objections. In this response, I propose a new autonomy-based objection to the PPP that is not explicitly discussed by Jardas et al. I call it the ‘objection from higher-order preferences’. Even if this objection is not sufficient reason to reject the PPP, the objection constitutes a pro tanto reason that is at least as powerful as the ones discussed by Jardas et al.