# Global Perspectives on Physician-Assisted Death: A Cross-Sectional Survey of Doctors’ Opinions

## TL;DR

This study surveyed doctors worldwide to understand their views on physician-assisted death, finding general support under strict safeguards, with regional differences in opinion.

## Contribution

The study provides cross-national insights into physicians’ attitudes toward physician-assisted death, highlighting regional and ethical variations.

## Key findings

- Most physicians supported legalizing PAD for mentally competent, terminally ill adults.
- Support declined for non-terminal physical and psychological suffering.
- Strong regional differences were observed, with more openness in the West and resistance in Northeast Asia.

## Abstract

Introduction

Physician-assisted death (PAD) remains ethically and legally contested worldwide. PAD encompasses both euthanasia and physician-assisted suicide, and is used interchangeably with assisted dying. While some countries have legalized PAD, many others continue to deliberate, some remain silent, and many don’t engage on this issue. Physicians’ perspectives are central to these discussions, yet cross-national data remain limited. This study seeks to explore these perspectives and identify the factors that influence them.

Methods

We conducted an anonymous, online cross-sectional survey of physicians’ opinions across 17 countries (n = 107). The questionnaire assessed demographics, clinical background, experiences with PAD and ethical/legal attitudes using Likert scales, checkboxes and free-text responses. This was disseminated through professional networks using online platforms.

Results

Of the 107 respondents, 55 (51.4%) practiced in Asia, 42 (39.3%) in the United Kingdom, and 10 (9.3%) in the United States, Europe, Oceania or Africa. Over half (n = 55, 51.9%) were aged between 25-34 years and nearly a quarter (n = 25, 23.4%) had more than 20 years of clinical experience across diverse specialties. Majority (n = 58, 54.2%) supported legalization of PAD for mentally competent, terminally ill adults, with declining support for non-terminal physical suffering (n = 47, 43.9%) and psychological suffering (n = 27, 25.2%). While views diverged on whether PAD undermines doctor-patient trust, most agreed it could coexist with palliative care. Legislative preferences varied widely, with leading support for legalizing PAD with strict safeguards (n = 39, 36.4%), while 15 (14.0%) preferred that it remain illegal.

Discussion

The findings of our survey align with published single-country studies which showed that majority supported PAD in restricted contexts. Ethical, cultural and professional concerns persist, with tension between autonomy and non-maleficence being a central theme. There seems to be a notable cross-sectional diversity with strong opposition from Northeast Asia and conservative regions and more openness in the West. These results should be interpreted considering study limitations, including the relatively small sample size and uneven representation across countries.

Conclusion

Doctors across multiple countries demonstrate nuanced but generally supportive views of PAD under strict safeguards.