top of page

The Who and How of 6-Steps

6-Steps is offered as a public service.  Unlike many other sites, everything on this site is free for the taking.


6-Steps was created by Richard B Stuart.  He has been committed to protecting patients’ rights throughout his professional career.  He is  Clinical Professor Emeritus in the Department of Psychiatry, University of Washington, and a member of the Medical Staff-Psychology at Swedish-Edmonds Hospital. During most of his institutional work he served on hospital ethics committees where he was frequently called upon to participate in making decisions about whether to offer or withhold various treatment options for very ill patients. Some patients had no advance directive and for others it was necessary to help loved ones overcome strong disagreements about what the patient would have chosen.  He is the author of more than 100 publications, was elected President of the Association for Behavioral and Cognitive Therapy, a Diplomate in Family Therapy American Board of Professional Psychology, and fellowship in two divisions of the American Psychological Association.  He has also served on the boards of various non-governmental organizations such as The Linehan Institute.

6-Steps began with a review of the literature on advance care planning that revealed that although the need was enormous and the effort was great, success was scarce.  So an attempt was made to create a process that overcame the many obstacles identified in earlier attempts.  The first draft of the protocol was used with a dozen patients who provided an opportunity to identify its weaknesses (and there were very many!).  It was repeatedly revised and field tested with patients individually and in groups, with the experience always resulting in changes, some big, others small.  The instrument has been used by hundreds of patients and community participants and has also been positively reviewed by numerous professional colleagues at various hospitals and universities.  It is the best draft to date, but certainly will not be the last.  Under the “Feedback” tab you will find an evaluation form.  If you are kind enough to complete it, your feedback can contribute to future revisions of what will hopefully be an ever-improving product.

Chief among the contributing professionals are:

Stephen Thielke MD, MSPH, MA

Associate Professor, Psyciatry

University of Washington


Cathe Clapp  RN MN, NEA-BC.

Director of Clinical Practice Development,

Swedish/Edmonds, Edmonds, WA


J. Randall Curtis MD MPH

Director, Cambia Palliative Care Center of Excellence, at University of Washington Medicine


Helen McGough MA



John Robinson  MD, SM.

Chief Medical Officer,

First Choice Health, Seattle WA


Ginny Weir  MPH.

Program Director, Bree Collaborative,

Foundation for Health Care Quality, Seattle, WA


John Barnett

Washington State Long-term Care Ombudsman Volunteer


Barbara J. Stuart PhD



bottom of page