A landmark report in Quebec recommends that doctors be allowed to help terminally ill patients die, in exceptional circumstances, if they want to.

The report was released Thursday in the Quebec legislature, after two years of work from the so-called Dying With Dignity Committee, a multi-partisan group of nine MNAs.

The argument for allowing euthanasia – even in some exceptional cases – could trigger a national debate again in Canada on the controversial issue.

In 1992, assisted suicide hit the national radar when 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 anyway with the help of an unidentified physician in 1994.

Since then, the issue has surfaced a number of times in court where people have been charged with helping loved ones die, including three such cases in Quebec in the past few years.

The committee examined questions about the end of life in producing a 180-page report, with 24 recommendations.

Many suggestions 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 that it is accessible to people with different illnesses no matter where they live, the committee says.

The report also suggests that the province's attorney general recommend to the Crown in Quebec that a doctor who has helped a terminally ill patient die not be charged in court.

That would be complicated. Euthanasia and assisted suicide are illegal in Canada under the Criminal Code. Commission members have acknowledged previously that their report would be unlikely to change that fact, but say it's clear that change is 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 committee, told a news conference.

"An improvement to the end-of-life care is important for the ill and their families."

The committee recommends a legal option for medical assistance for dying, in cases where Quebecers are terminally ill and want to die.

In those cases, a patient must be an adult, suffering from an incurable disease and demonstrating an inability to endure the physical or psychological pain.

The request for help in dying must come directly from the patient, with two doctors certifying the request.

Quebec's public hearings into dying with dignity spanned months, hearing from individuals and experts both here and abroad.

The commission heard from 400 witnesses and read through 300 submissions. A delegation went to France, the Netherlands and Belgium to see how the debate over dying with dignity is playing out in Europe.

"This mission was enlightening for our deliberations," Gaudreault told a news conference.

The recommendations aren't binding, but to ensure the report doesn't end up on a shelf the committee is recommending a law be adopted by June 2013.