Quebec's bill to legalize medically assisted suicide has the support of all four parties in the province's national assembly.  However, support for Bill 52 is far from unanimous, especially among doctors who would be expected to act on a patient's request for help in dying.

The Physicians' Alliance for Total Refusal of Euthanasia condemned the bill, accusing the Marois government of caving in to "small but persistent" lobby groups and pushing Quebecers onto a dangerous path.

"This is not a small opening," said Dr. Marc Beauchamp, the orthopedic surgeon who is the spokesman for the alliance. "It's an enormous door, an enormous revolution in ethics and law."

Beauchamp accused Social Services Minister Véronique Hivon, who tabled the bill Wednesday morning, of resorting to euphemistic language to skirt around exactly what the government is asking Quebec physicians to do.

"Active euthanasia — what Mme. Hivon calls medical aid in dying — is to fill a syringe with a deadly substance and inject it, such that the person dies a few seconds or a few minutes later," said  Beauchamp. 

'I don't want to continue in that field if the law passes,'—Palliative care physician Dr. Gerald Van Gurp

"I'm not going there," said Dr. Gerald Van Gurp, a Montreal family doctor who specializes in home palliative care for terminally ill patients.

The bill would not oblige any physician to end a patient's life, but it would require a doctor who refuses to inform his or her supervisor of a patient's request, so that a willing doctor could be found.

That opt-out provision gives Van Gurp little solace.

"I don't want to continue in that field if the law passes, basically," he said. 

Van Gurp said most of the time, patients who request help in dying are in psychological turmoil and in physical pain. However, in his 30 years of palliative care practice, he says he's rarely encountered a case where a patient's pain cannot be relieved.

"Once you relieve the pain, once you get a supportive relationship — you have nurses, doctors coming [into their home] they don't want the lethal injection anymore."

He said by some estimates, only 10 or 20 per cent of terminally ill Quebecers have access to that kind of high quality palliative care.

"So there are a lot of people suffering, in pain," Van Gurp said. "But the solution is not to introduce euthanasia, it's to introduce high quality palliative care. Not expensive. Not high tech. But you need responsive doctors and nurses."

Van Gurp, who was born in the Netherlands, said evidence in his native country and in neighbouring Belgium shows what a slippery slope opening the door to "right-to-die" legislation can lead to.  He said there is pressure from some groups in Belgium to amend its legislation to make medically assisted suicide an option for patients suffering from Alzheimer disease.

Federal government will review bill's implications

Federal Justice Minister Rob Nicholson says the government will review the implications of Quebec's proposed legislation.

"The laws that prohibit euthanasia and assisted suicide exist to protect all Canadians, including those who are potentially the most vulnerable, such as people who are sick or elderly, and people with disabilities," said Nicholson in a statement.

He said the Supreme Court of Canada upheld the constitutionality of the existing law against assisted suicide in the Sue Rodriguez case in 1993, and three years ago, parliament voted not to change the law.

"This is a sensitive issue for many Canadians, with deeply held beliefs on both sides of the debate," said Nicholson.