The purpose of this study was to gain insight into developmental and contextual correlates of the aggressiveness in treatment that community-based elders anticipate they will desire at the end of life. Elders completed questionnaires to measure 4 developmental factors (integrated moral reasoning, self-transcendence, past experience with life-threatening illness, and age) and five contextual factors (education level, gender, ethnicity, current health status, and completion of a living will). The variance in desired aggressiveness in treatment was explained by both developmental and contextual correlates. Integrated moral reasoning emerged as a new variable to consider in gaining understanding of the process of end-of-life decisions.