Dr. Jose Pereira spoke at a news conference Thursday in Ottawa. (CBC)

The legalization of euthanasia and assisted suicide in Canada could reduce the level of care available to those with terminal illnesses, an Ottawa doctor warns.

"We need to improve care, not terminate it," Dr. Jose Pereira told reporters at a news conference Thursday.

Pereira, chief of palliative medicine at the long-term-care hospital Bruyère Continuing Care in Ottawa, specializes in caring for and improving the quality of life for patients who are terminally ill or require long-term care.

He said he is concerned about a private member's bill to legalize euthanasia after his experience in Switzerland, which already allows the practice.

While working at a hospital in Geneva, Pereira said, he noticed that a few months after the hospital began offering assisted suicide, community-based palliative care services were shut down and the number of palliative-care physicians at the hospital was reduced.

Pereira, who is also a University of Ottawa professor who heads the university's palliative-care program, said he is concerned that a similar "social slippery slope" could appear in Canada if Bill C-384 is passed.

Pereira's concerns were echoed by Jean Bartkowiak, president and CEO at Bruyère.

"We must not abandon these vulnerable people through assisted suicide and euthanasia, but instead embark on a quest to find better ways to maintain their dignity and quality of life," he said. He added that he hears daily about patients recovering from dire situations, and said people should never lose hope.

Bloc Québécois MP Francine Lalonde tabled her private member's right-to-die bill in May 2009. The bill would amend the Criminal Code so a doctor can assist a consenting terminally ill patient or a patient in severe physical or mental pain "without any prospect of relief … to die with dignity."

'Serious flaws'

Pereira said there are "serious flaws" in the bill:

• It isn't limited to people with terminal illnesses, but also mental illnesses.
• It allows people to refuse appropriate treatment and choose euthanasia.
• It doesn't define "terminal."
• It allows people to consent to assisted suicide if they appear to be lucid, a qualification Pereira said is "too ambiguous."

He added that other jurisdictions have found it hard to put in "foolproof safeguards" to prevent people who don't meet the criteria — such as people with depression — to be eligible for euthanasia,

Pereira also expressed concerns about what legalizing euthanasia would mean for doctors.

"It's taking away the right of most physicians to say, 'No, this is not something that we do.'"

A number of other groups have expressed concerns about the bill. Steve Passmore, a spokesman for a group called the Euthanasia Prevention Coalition, believes it represents a threat to people with disabilities, such as himself.

In August, a group of about 100 Quebec doctors submitted a brief to Quebec's College of Physicians urging it to reconsider its proposal to tolerate assisted suicide in "appropriate circumstances."