]. in these vignettes, we also analyzed the effects of using different health persuasive framings (gain or loss) in com- bination with an ethical decision, in which the healthcare agent has accepted the patient decision to refuse medica- tion (respecting the patient autonomy) or has not accepted (by prioritizing the beneficence and nonmaleficence of the patient health). these principles have also been considered the most relevant in bioethics [ 7 ]. the autonomy principle refers to respecting the patient’s right to freely control his/ her own health outcomes, whereas the beneficence principle involves the healthcare actions intended to maximize the patient’s health, and nonmaleficence refers to the duty to not cause harm nor impose risks of harm to patients [ , 8 ]. in our study, we combined the beneficence/nonmaleficence principles, since not accepting the patient’s refusal to take medication is expected to lead to health benefits and the avoidance of harm [ ]. our study extends previous research [ 9 ], focusing on a potential healthcare situation in which a patient refuses to take medication. we tested how different health framing messages to persuade patients to take medication in combi- nation with distinct ethical decisions impact people’s moral