["Medical Anthropology Quarterly, EarlyView. ", "\nAbstract\nThis article uses case studies to explore the nature and limits of accompagnement, the self‐consciously “relational” care practiced by palliative care providers in Montagnac, a town in southern France. Medical anthropologists have attended to the ways that care premised on individual choice often fails as care, particularly for marginalized patient groups presumed to be incapable of making “good” decisions. This paper asks when, where, and why self‐consciously relational care like accompagnement might also fail. I argue that despite a claim to “meet patients where they are,” accompagnement, like choice, requires providers to project their own assumptions about the nature and telos of human beings onto their patients. When patients fail to mirror those assumptions, “relationality” quickly turns into paternalism. This argument complicates medical anthropology's embrace of relationality as an antidote to the violence associated with choice‐based models of medicine.\n"]