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

Grove, GL; Lovell, MR; Butow, P; Hughes, I; Best, M

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

Grove, GL Lovell, MR Butow, P Hughes, I Best, M

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Publisher:: Cambridge University Press (CUP)
Publication Type:: Journal Article
Citation:: Palliat Support Care, 2025, 23, pp. e153
Issue Date:: 2025-09-03

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Field	Value	Language
dc.contributor.author	Grove, GL
dc.contributor.author	Lovell, MR
dc.contributor.author	Butow, P
dc.contributor.author	Hughes, I
dc.contributor.author	Best, M
dc.date.accessioned	2026-08-05T00:33:02Z
dc.date.available	2026-08-05T00:33:02Z
dc.date.issued	2025-09-03
dc.identifier.citation	Palliat Support Care, 2025, 23, pp. e153
dc.identifier.issn	1478-9515
dc.identifier.issn	1478-9523
dc.identifier.uri	http://hdl.handle.net/10453/195927
dc.description.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.
dc.format	Electronic
dc.language	eng
dc.publisher	Cambridge University Press (CUP)
dc.relation.ispartof	Palliat Support Care
dc.relation.isbasedon	10.1017/S1478951525100655
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Oncology & Carcinogenesis
dc.subject.classification	4203 Health services and systems
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Palliative Care
dc.subject.mesh	New South Wales
dc.subject.mesh	Queensland
dc.subject.mesh	Middle Aged
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Adult
dc.subject.mesh	Suicide, Assisted
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Health Personnel
dc.subject.mesh	Grounded Theory
dc.subject.mesh	Interviews as Topic
dc.subject.mesh	Humans
dc.subject.mesh	Palliative Care
dc.subject.mesh	Suicide, Assisted
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Health Personnel
dc.subject.mesh	New South Wales
dc.subject.mesh	Queensland
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Interviews as Topic
dc.subject.mesh	Grounded Theory
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Palliative Care
dc.subject.mesh	New South Wales
dc.subject.mesh	Queensland
dc.subject.mesh	Middle Aged
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Adult
dc.subject.mesh	Suicide, Assisted
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Health Personnel
dc.subject.mesh	Grounded Theory
dc.subject.mesh	Interviews as Topic
dc.title	Shaping a knowable event or embracing a mysterious journey: A mixed methods study on palliative care clinician views on voluntary assisted dying.
dc.type	Journal Article
utslib.citation.volume	23
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/UTS Groups
pubs.organisational-group	University of Technology Sydney/UTS Groups/Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT)
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2026-08-05T00:33:00Z
pubs.publication-status	Published online
pubs.volume	23

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.

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http://hdl.handle.net/10453/195927