A patient follows straightforward, reasonable instructions during an examination but declines an instruction that would cause obvious pain, explaining that it would hurt. Before revealing the answer: is this automatic obedience?

No. Automatic obedience is distinguished from ordinary cooperativeness by the indiscriminate nature of the compliance and its persistence despite direct experience of an unpleasant consequence. Here, the patient exercises ordinary judgement, weighing the instruction and declining the one that would cause pain while explaining why — this is simply reasonable, everyday cooperation with limits, not the indiscriminate, unmodified compliance regardless of consequence that defines automatic obedience. A patient retaining ordinary judgement about which instructions to follow is, if anything, evidence against automatic obedience being present.