It is sometimes morally permissible not to help others even when doing so is overall better for you. For example, you are not morally required to take a career in medicine over a career in music, even if the former is both better for others and better for you. I argue that the permissibility of not helping in a range of cases of “compensated altruism” is explained by the existence of autonomy-based considerations. I sketch a view according to which you (...) can have autonomy-based permissions to choose between alternatives when these alternatives differ in terms of the valuable features they instantiate. Along the way, I argue that considerations of moral autonomy do not support rejecting the plausible view that we each constantly face reasons with morally requiring strength to help (distant) strangers. (shrink)