This three-step process has been compiled for guardians who have been given the responsibility to make decisions on behalf of people who have never been able to express their intentions about end-of-life care and life-sustaining treatments. Following the THINK-ASK-PLAN (TAP) process, guardians can be better prepared to make end-of-life decisions and treatment options for people who are unable to communicate their wishes.

STEP 1: THINK

Use this Ethics Workup Exercise to explore end-of-life care, and the act of making decisions about health care treatment on another person’s behalf. This exercise provides a framework for applying ethical decision-making about health care treatment using case analysis of five scenarios. Use the Ethics Workup Case Analysis to review and understand the principal steps needed to discuss morally complex cases. Regardless of your philosophical or religious framework, this analysis will help you create a basic framework to address these morally complex end of life care.

STEP 2: ASK

Guardians and caregivers can use the Guided Interview for Decision-makers to gather information about the person with significant disability for whom they are legally responsible. It is helpful in this step to collaborate with the person’s support circle to collect information about the person’s personality, beliefs, and interests. This exercise prepares decision-makers to meet with the person’s healthcare professional in the next step.

STEP 3: PLAN

Guardians and caregivers may use this Quality of Life Considerations to assess various medical decisions and the impact of the decisions on the quality of life of the person with developmental disability for whom they are responsible.