Aims were to determine acceptability of a full range of end-of-life decision options and identify related variables; 388 Black and White older adults ages 60-100 responded to 17 decision situations depicting terminal and nonterminal conditions with a very low quality of life, rating the acceptability of 7 end-of-life options per decision situation, and completed demographic, health, and psychosocial measures. Despite low quality of life, maintaining life (striving to live and seeking treatment) was the most acceptable option, but a significant minority of participants wished to end life (suicide, assisted suicide, or euthanasia) and a moderate number wished to defer the decision to others. In hierarchical regressions, psychosocial variables (religiosity, values, fear of death, etc.) contributed significantly (p < .05) to decisions beyond the effects of demographic and health variables.