Abstract The Last Passages project has been discussing end-of-life care for people with developmental disabilities for the past three years. The project has gathered best practices information and disseminated it through training, publications and websites. This response reflects many of the discussions, policy recommendations and philosophy of care developed by the Last Passages project. We believe we must insure that each person, regardless of their disability, has the opportunity to make end-of-life care choices, or have them made by family members and/or friends whom they trust, and that those choices be respected and supported by health care providers and the legal system.