Attitudes Toward Medical Assistance in Dying Among Swedish Palliative Care Professionals

The debate over legalizing medical assistance in dying (assisted dying) is ongoing, also in Nordic countries such as Sweden where assisted dying is illegal. A 2020 survey by the Swedish Medical Association highlighted varied perspectives, with 41% of physicians supporting and 34% opposing legalization. Professionals in palliative care were more negative toward it. To assess attitudes toward the legalization of, and the need for education about, assisted dying among Swedish palliative care professionals. A survey with 19 closed- and 2 open-ended questions was administered to the participants of the 2023 Swedish National Conference on Palliative Care (including physicians, nurses, assistant nurses, administrators, and researchers). Of the 866 conference participants who were invited, 444 (51%) participated. Predominantly, the cohort comprised women (89%); 60% were nurses and 17% physicians. The results showed that 38% opposed euthanasia, 36% supported it, and 26% remained undecided, with similar findings regarding physician-assisted suicide. There was a significant trend of increasingly negative attitudes with age and experience in palliative care (p < 0.01). Physicians emerged as the group most opposed to euthanasia (80%), whereas assistant nurses were the most positive, with 13% opposing legalization, and 33% of the nurses opposed euthanasia. The open-ended questions revealed thoughts regarding the complexity of the issue and the need for further discussion and education. In Sweden, where euthanasia and physician-assisted suicide is illegal, more than one-third of palliative care professionals were in favor of legalizing these practices while one-fourth were undecided, these proportions differed markedly between professions. Further, we uncovered a significant need for further discussion and education.