This law review article – 40 J. of Legal Medicine 63 (2020) – provides a conceptual framework and practical guidelines for applying the do not oppose prong of the Court’s Olmstead test. It seeks to demonstrate that both Olmstead and the ADA require that a decision to remain in a segregated setting must be a knowing and informed choice made by the individual, with accommodations to both the person’s disability and the vestiges of institutionalization. It argues that, where the person is under guardianship, any decision to oppose integration should be subject to judicial review and approval.