Globally, self-neglect is recognized as a serious and complex public health issue. Self-neglect can vary in presentation and severity and is mainly characterized by profound environmental neglect and cumulative diverse behaviors that may threaten a person’s ability to live safely and independently in the community. Supporting people who self-neglect can give rise to significant ethical, professional, and personal challenges. The purpose of this chapter is to examine ethical decision making pertaining to selfneglect. An ethical decision-making tool is described and applied to a case example of self-neglect. The tool provides a step-by-step framework of actions and responsibilities to critically reflect on and respond to an ethically challenging self-neglecting individual. The tool highlights the key components of the ethical decision-making process and may contribute to building ethical capacity and confidence among health and social care professionals. Ethical frameworks have the potential to improve care and outcomes for self-neglecting clients.