How to answer a question on euthanasia and physician-assisted death in a medical school interview

A strong answer to "what is your view on physician-assisted death" defines the terms before it gives an opinion, sets out the best case on each side, and takes a position you can defend. Questions on euthanasia in a medical school interview test ethical reasoning, accuracy and compassion at once, and no particular conclusion is the right one.

What the interviewer is assessing

• Ethical reasoning
• Empathy and compassion
• Critical thinking

The interviewer isn't grading your conclusion. They want to see whether you can define a contested issue precisely, state the opposing argument fairly, and still commit to a view. They also listen for compassion: whether the suffering patient stays in the answer or disappears behind the law. Panel follow-ups push on the weakest part of your answer, and an MMI may set the question as an acting station in which a patient raises it.

The definitions come first. Euthanasia is a clinician administering a medication with the intention of ending a patient's life, at that patient's request. Physician-assisted death, also called physician-assisted suicide or medical aid in dying, is a physician prescribing a medication that the patient takes themselves.

The law differs by country. In Canada, medical assistance in dying (MAID) is legal under federal law, covers both forms, and has eligibility criteria that include capacity, a voluntary request and a grievous and irremediable medical condition. In the US, medical aid in dying is legal only in some states and is limited to self-administered medication for terminally ill adults. Euthanasia is not legal in any US state.

How to structure your answer

1. Define euthanasia and physician-assisted death in one sentence each, and say which one the question is about.
2. State the law where you're interviewing in a sentence, without claiming it applies everywhere.
3. Name the people with a stake: the patient, their family, the clinicians, including those who object, people with disabilities and the system that funds palliative care.
4. Give the strongest argument on each side, using autonomy (the patient's right to decide), beneficence (acting for the patient's good), non-maleficence (avoiding harm) and justice (fairness across patients).
5. Take a position, say which consideration weighs most for you, and say what would change your mind.
6. Finish with what you'd do when a patient raises it: listen, ask what is driving the request, confirm that palliative care has been offered, and know what the law requires of you.

The case for rests on autonomy and on relief of suffering that palliative care can't reach. The case against rests on non-maleficence, on the risk to people with disabilities and to people without access to care, on the difficulty of assessing capacity, and on trust in physicians. Conscientious objection cuts across both: some jurisdictions require an objecting physician to refer the patient to a colleague, and others don't. Define quickly, and spend most of the three minutes on the arguments.

Common mistakes

• Treating euthanasia and physician-assisted death as the same thing shows you haven't done the reading, and the interviewer may stop you to correct it.
• Stating one country's law as if it applied everywhere costs you credibility with an interviewer who practices under another.
• Giving only one side tells the interviewer you haven't considered the people who disagree with you.
• Refusing to take a position reads as evasion, because the question asked for your view.
• Leaving the patient out of an answer about law and principle misses the compassion the question also tests.

Follow-up questions to prepare for

• What would you do if an eligible patient asked you for help to die and you objected on grounds of conscience?
• Should a person whose only condition is a mental illness be eligible?
• How would you make sure a request wasn't driven by poverty, isolation or a lack of care?
• What is the difference between withdrawing life-sustaining treatment and physician-assisted death?