Physician-assisted suicide (PAS) is a highly debated issue. The Sue Rodriguez case highlighted the importance and the contentious nature of this issue in our society today. This study assessed attitudes towards PAS held by first and fourth year medical students at the University of Western Ontario via a 13 question anonymous survey. One hundred and twenty-four surveys were returned with a response rate of 53%. Respondents, especially those in fourth year, were unwilling to aid in PAS in the capacity of physicians (63% overall unwilling; P = 0.004). They wanted PAS to be an option, however, if they were patients themselves (64% overall; P = 0.002). A variety of factors were considered important in making decisions regarding PAS, especially a patient's clear understanding of medical management options. Most respondents welcomed (39%) or were neutral (45%) towards legalization of PAS. Opinions towards PAS tended not to change over the course of medical school (72% overall; P < 0.001). Students generally favoured the concept of PAS as long as they did not have to take part in it themselves. Although no differences between first and fourth year medical students were detected concerning their opinions towards PAS, willingness to participate may be affected by personal experience with patients.