title: Exploring the interface between 'physician-assisted death' and palliative care: cross-sectional data from Australasian palliative care specialists.
abstract: BACKGROUND
  Legalisation of physician-assisted dying (PAD) remains a highly contested issue. In the Australasian context, the opinion and perspective of palliative care specialists have not been captured empirically, and are required to inform better the debate around this issue, moving forward.
  
  
  OBJECTIVE
  To identify current attitudes and experiences of palliative care specialists in Australasia regarding requests for physician-assisted suicide and voluntary euthanasia, and to capture the opinion of palliative care specialists on the legalisation of these practices in the Australasian context.
  
  
  METHODS
  An anonymous, cross-sectional, online survey of Australasian specialists in palliative care, addressing the following six areas: (i) demographics; (ii) frequency of requests, and response given; (iii) understanding of the term 'voluntary euthanasia'; (iv) opinion regarding legalisation of physician-assisted suicide and voluntary euthanasia in Australasia, and willingness to participate if legal; (v) identification of the most important values guiding this opinion; and (vi) anticipated impact that legalisation of assisted death would have on palliative care practice.
  
  
  RESULTS
  Important findings include: (i) palliative care specialists are largely opposed to the legalisation of PAD; (ii) the proportional titration of opioids is not understood by any palliative care specialist studied to be 'voluntary euthanasia'; and (iii) there is a wide variation in frequency of requests, and one-third of palliative care specialists express discomfort in dealing with requests for assisted suicide or euthanasia.
  
  
  CONCLUSIONS
  Key areas for future research at the interface between PAD and best practice end-of-life care are identified, including exploration into why palliative care specialists are largely opposed to PAD, and consideration of the impact 'the opioid misconception' may have on the literature informing this debate.
authors.affiliation: St George and Calvary Hospitals, Sydney, New South Wales, Australia.|Centre for Values Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia.|Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada.|School of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Sheahan
mesh_terms: D001291:Attitude of Health Personnel; D044362:Australasia; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods* / Q000523:psychology* / Q000639:trends; D065126:Palliative Medicine / Q000379:methods / Q000639:trends; D010820:Physicians / Q000523:psychology* / Q000639:trends; D017236:Suicide, Assisted / Q000523:psychology* / Q000639:trends; D011795:Surveys and Questionnaires
keywords: end-of-life care; euthanasia; palliative care; physician aid in dying; physician-assisted death; physician-assisted suicide