Changing perspectives on participation in assisted dying in Queensland, Australia: A one-year qualitative longitudinal study of doctors.

Although assisted dying (AD) is increasingly legalized globally, in limited circumstances, many doctors choose not to participate. This study is the first qualitative longitudinal study comparing doctors' intentions to participate in AD in Queensland, Australia to actual participation, to identify any changes. Semi-structured interviews were conducted with 27 doctors at two time points: after the law passed but before AD was legally available and one year after the law commenced operation. 19 of these 27 doctors originally planned to participate and 13 went on to do so. Thematic and longitudinal analysis identified three categories of participation: participation matched initially planned; less participation than initially planned; and more participation than initially planned. The two main factors affecting changes in participation were the lack of remuneration and system design for AD in Queensland. Both should be addressed to ensure AD service sustainability and continued participation of doctors who choose to provide AD.