In "The Heart Goes Last," Margaret Atwood explores themes of autonomy and responsibility through a dystopian lens. The narrative suggests a societal inclination towards relinquishing personal decision-making, resulting in characters grappling with the consequences of their choices. This loss of agency raises questions about moral accountability and the impact of external control. Through the story's progression, it becomes evident that the desire to escape responsibility can lead to deeper ethical dilemmas.

Atwood's quote, "You want your decisions taken away from you so you won't be responsible for your own actions?" encapsulates a key tension within the characters’ lives. It highlights a common human desire to avoid the burden of judgment and consequences. The novel poignantly reminds readers of the importance of embracing one's freedom and the responsibilities that come with it, urging a reconsideration of how people navigate their lives in a world that increasingly seeks to dictate their choices.