Shaping a knowable event or embracing a mysterious journey: A mixed methods study on palliative care clinician views on voluntary assisted dying

Topic: Risk, prevention and care in population studies

Abstract Objectives This study explored Australian palliative care clinicians’ perspectives on the legalization of voluntary assisted dying (VAD), aiming to identify variables associated with clinicians’ views and understand challenges of its implementation. Methods An online survey exploring support for legalization of VAD was sent to palliative care clinicians in Queensland and New South Wales and followed up with semi-structured interviews. Support was categorized as positive, uncertain, or negative. An ordinal logistic regression model was used to identify variables independently predictive of euthanasia support. Interviews were analyzed using grounded theory to understand key concepts shaping views on VAD. Results Of 142 respondents, 53% supported, 10% were uncertain, and 37% opposed legalizing euthanasia for terminal illness with severe symptoms. Support was lower for patients with chronic illness (34%), severe disability (24%), depression (9%), severe dementia (5%), and for any adult with capacity (4%). The model showed lower support among doctors than nurses (38% vs. 69%, p = 0.0001), those in New South Wales compared with Queensland (44% vs. 69%, p = 0.0002), the highly religious versus least religious (24% vs. 79%, p = 0.00002), those politically conservative versus progressive (39% vs. 60%, p = 0.04), and those with more healthcare experience (p = 0.03). Seventeen interviews revealed 2 distinct groups: one focused on the event of death and the need to relieve suffering, providing comfort in the final moments; the second on the journey of dying and the possibility of discovering peace despite suffering. Those in the first group supported legal VAD, while those in the second opposed it. Despite opposing views, compassion was a unifying foundation common to both groups. Significance of results There are 2 fundamentally different orientations toward VAD among palliative care clinicians, which will likely contribute to tensions within teams. Acknowledging that both perspectives are rooted in compassion may provide a constructive basis for navigating disagreements and supporting team cohesion.

Key findings

• Abstract Objectives This study explored Australian palliative care clinicians’ perspectives on the legalization of voluntary assisted dying (VAD), aiming to identify variables associated with clinicians’ views and understand challenges of its implementation.
• Results Of 142 respondents, 53% supported, 10% were uncertain, and 37% opposed legalizing euthanasia for terminal illness with severe symptoms.
• The model showed lower support among doctors than nurses (38% vs. 69%, p = 0.0001), those in New South Wales compared with Queensland (44% vs. 69%, p = 0.0002), the highly religious versus least religious (24% vs. 79%, p = 0.00002), those politically conservative versus progressive (39% vs. 60%, p = 0.04), and those with more healthcare experience ( p = 0.03).
• Seventeen interviews revealed 2 distinct groups: one focused on the event of death and the need to relieve suffering, providing comfort in the final moments; the second on the journey of dying and the possibility of discovering peace despite suffering.
• Significance of results There are 2 fundamentally different orientations toward VAD among palliative care clinicians, which will likely contribute to tensions within teams.

Why it matters

This mixed methods study of Australian palliative care clinicians found support for legalizing voluntary assisted dying was lower for patients with severe dementia (5%) than for terminal illness with severe symptoms overall. It identified variables associated with clinicians' views and challenges of implementation.

Study details

• Evidence strengthLow

Read the original

• DOI: 10.1017/s1478951525100655
• PubMed: 40899252
• Original source →
• Free full text: Palliative & Supportive Care →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{grove2025-40899252,
  author  = {Grove, Graham Llewellyn and Lovell, Melanie R and Butow, Phyllis Noemi and Hughes, Ian Paul and Best, Megan C},
  title   = {{Shaping a knowable event or embracing a mysterious journey: A mixed methods study on palliative care clinician views on voluntary assisted dying}},
  journal = {Palliative \& Supportive Care},
  year    = {2025},
  doi     = {10.1017/s1478951525100655},
  pmid    = {40899252},
  url     = {https://doi.org/10.1017/s1478951525100655}
}

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