National study of medical education, ethical attitudes and curricular exposure to voluntary assisted dying by VOICE (Views Of Incoming Clinicians on End-of-life care)

Background: Legislative moves to legalise assisted dying in the UK have renewed discussion on future clinicians' preparedness for new potential responsibilities. This study examined medical students' ethical attitudes, legal understanding and curricular exposure. Methods: VOICE was a national cross-sectional survey of UK and Ireland medical students in 2025 (n = 896). The questionnaire assessed ethical views, confidence, legal knowledge and teaching exposure. Descriptive statistics, thematic analysis and multivariable logistic regression explored predictors of ethical agreement, curriculum coverage and legal knowledge. Results: Most students (64.5%) believed that assisted dying can be ethically justified, yet legal knowledge was limited; only 7.6% correctly identified all eligibility criteria. Nearly 70% reported minimal curricular coverage. Formal teaching was associated with higher confidence and greater ethical agreement. Regional variation and concerns about coercion and inequalities were common. Conclusion: Students show broad ethical support but have very limited confidence, legal understanding and curricular preparation, highlighting the need for structured education.