Understanding Palliative Care Physicians’ Perspectives Regarding the Intersection of Palliative Care and Medical Assistance in Dying in Ontario, Canada

Background: Medical Assistance in Dying (MAiD) and palliative care are often portrayed as oppositional practices due to the belief that the former hastens death while the latter focuses on life-affirming approaches to symptom management. As Canada’s MAiD program expands, the shared focus on end-of-life care raises the question of whether this divide in provision should proceed or if integration of MAiD with palliative care is possible from the perspective of clinicians. Objective: The objective of this study is to explore Ontario palliative care physicians’ perspectives on the potential integration of MAiD within palliative care services. Design: This study utilizes a qualitative descriptive study design. Setting/Subjects: Seventeen palliative care physicians practicing across Ontario were interviewed from February to May 2025. Six abstained from involvement with MAiD, seven acted as assessors and providers, and four acted as assessors only. Measurement: Virtual semi-structured interviews and thematic analysis to identify dominant patterns and beliefs. Results: Our data analysis spanned four main themes: (1) ethical interpretations of the act of MAiD as determinants of inclusion or exclusion, (2) integration versus separation of MAiD and palliative care, (3) MAiD as patient-centered care, and (4) potential negative consequences of MAiD integration. Conclusion: Participants offered varying opinions on the ethical appropriateness of offering MAiD through palliative care, yet all acknowledged the importance of respect for patient choice and provision of a full range of medical treatments for high-quality patient care. Findings highlight the need for nuanced policy and supportive professional environments as palliative care clinicians navigate this ethically complex terrain.