In this article, the authors challenge professionals to re-examine assumptions about basic concepts and their implications in supporting adults with intellectual and developmental disabilities. The authors focus on decisions with significant implications, such as planning transition from school to adult life, changing living environments, and managing health issues. The analysis highlights important concepts that are less often addressed: autonomy, empowerment, participation in decision making, asymmetrical power, outer-directedness, and respect for persons. The authors suggest that professionals adopt a moral principle of respect for persons as an overarching guiding principle in their work with adults with intellectual and developmental disabilities. The value of self-determination and person-centered planning processes are placed in the larger scope of ethical practice. The authors offer a set of practical considerations that encourage respect for these individuals by involving them in the decision-making process in situations that have a large impact on them.