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We proposed a novel palliative care scale (Amyotrophic Lateral Sclerosis Palliative Care Scale ALSPCS) for patients with ALS, and analyzed the suffering reported by patients. Thirty-one patients participated in the study. The ALSPCS has 15 items to evaluate physical and psychological suffering; patients scored their subjective suffering on a scale of 0-5 for each item. This study analyzed 13 of 15 items. The mean scores obtained from the patients were as follows 'dyspnea', 2.5; 'pain', 2.4; 'restlessness', 2.4; 'thirst', 3.0; 'burning se