The report was released in the legislature on Thursday after two years of work from the so-called Dying With Dignity Committee, a multi-partisan group of MNAs.
The report focuses mainly on improving palliative care but the argument for opening the door to euthanasia — albeit in some very exceptional cases — could trigger a national debate again in Canada on the controversial issue.
The report opens the door to euthanasia, which is specifically called medically assisted death.
But the committee opposes assisted suicide, which consists of helping someone die when he or she hasn't arrived at the end of life.
"Our mandate was to look at the conditions at the end of life, so we felt that it (assisted suicide) was away from our mandate," said Veronique Hivon, a Parti Quebecois member and co-president of the committee.
"We feel that society puts so much effort and emphasis to fight for life and fight against suicide that we can't send a contradictory message."
Euthanasia and assisted suicide are illegal in Canada under the Criminal Code. In Ottawa, a spokesperson for Justice Minister Rob Nicholson said that wouldn't change.
"Euthanasia and assisted suicide raise complex ethical, legal and medical issues, many of them involve competing interests," Julie Di Mambro said in an email.
"Our laws are in place to protect all persons, including those who are more vulnerable such as the sick, elderly and disabled. Parliament has already voted on this issue and we will respect the will of Parliament."
It's a debate that Canadians have grappled with for nearly two decades.
In 1992, assisted suicide hit the national radar when Sue Rodriguez, a B.C. woman, fought all the way to the Supreme Court of Canada for the right to kill herself. Rodriguez, who suffered from Lou Gehrig's disease, lost 5-4 in a split decision. She killed herself in 1994 with the help of an unidentified physician.
Since then, the issue has surfaced several times in court, with people being charged with helping loved ones die. There have been three such cases in Quebec in the past few years.
The Rodriguez case changed the way B.C. prosecuted such cases, setting out criteria and guidelines.
Provinces are free to decide how to apply the laws governing euthanasia and assisted suicide.
The Quebec report suggests the province follow the B.C. example: that the attorney general recommend to the Crown in Quebec that no charges be laid against doctors who help a terminally ill patient die.
The committee previously acknowledged that its report likely wouldn't lead to changes in the Criminal Code. But the politicians who sat on the committee say it's clear some modifications are necessary.
"No one wants the status quo, everyone recognizes that there are holes in the system and we can do better," Maryse Gaudreault, a Liberal member who co-chaired the group, told a news conference.
"An improvement to the end-of-life care is important for the ill and their families."
The committee's 180-page report includes 24 recommendations.
Many revolve around improving palliative care, which the report says would suffice in most medical cases.
Receiving that care should become a legally recognized right so it is accessible to people with different illnesses no matter where they live in the province, the committee says.
The committee also recommends a legal option for medical assistance for dying, in cases where Quebecers are terminally ill and want to die. The fundamental criterion is that the person suffering must ask for it.
In those cases, the patient must be an adult living in Quebec, suffer from an incurable disease and demonstrate an inability to endure the physical or psychological pain.
Two doctors must certify the request.
Various organizations and groups, including many that presented briefs during the hearings, weighed in Thursday.
One association representing doctors for social justice said they rejected any form of euthanasia — even in exceptional circumstances.
A group representing social workers and marriage counsellors applauded the report and encouraged the government to move forward.
Meanwhile, a retirees association, called on the government to deal with issues surrounding palliative care before dealing with doctor-assisted death. The group said it did not have a position on any form of assisted death.
The public hearings spanned months and heard from individuals and experts both here and abroad. The committee heard from 400 witnesses and read 300 submissions.
A delegation went to France, the Netherlands and Belgium to examine how the debate over dying with dignity was playing out in those countries. In Europe, there are deep divisions over how to respond to the requests of the terminally ill.
"This mission was enlightening for our deliberations," Gaudreault said.
The committee's recommendations aren't binding and it is recommending that a law be adopted by June 2013.
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