The study objective is to determine if quality of care, symptoms of depression, disease characteristics & quality of life of patients with ALS are related to requesting EAS & dying due to EAS. … 31% of patients requested EAS, 69% of whom eventually died as a result of EAS (22% of all patients). 10% died during CDS; only 1 of them had explicitly requested death to be hastened. Of patients who requested EAS, 86% considered health care to be good or excellent, 16% felt depressed, 45% experienced loss of dignity & 42% feared choking. These percentages do not differ from the number of patients who did not explicitly request EAS. … Our findings do not support CDS being used as a substitute for EAS. In this prospective study, no evidence was found for a relation between EAS & the quality & quantity of care received, quality of life & symptoms of depression in patients with ALS. Our study does not support the notion that unmet palliative care needs are related to EAS.