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OTTAWA – The Conservative government refuses to reopen a debate about euthanasia and assisted suicide even though its own bureaucrats say that’s what Canadians want.

Briefing notes prepared for Health Minister Rona Ambrose in advance of a provincial health ministers’ meeting last month acknowledge a “growing demand” for death with dignity in Canada.

“Concerns about suffering and loss of autonomy at the end of life have led to a growing demand for euthanasia and physician-assisted suicide,” says the document, obtained under access to information.

The note gives four reasons why the issue has gained prominence:

– A British Columbia court case that seeks to legalize doctor-assisted suicide is being appealed to the Supreme Court;

– The Quebec government’s Bill 52 on “medical aid in dying,” which is being studied by the provincial National Assembly;

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– A video from Canadian microbiologist Donald Low, who pleaded for assisted suicide to be legal eight days before he died from a brain tumour;

– Recent comments from Manitoba Conservative MP Steven Fletcher, who is quadriplegic and believes in assisted suicide in some cases

“We need to have this discussion as a society,” Fletcher said in an interview. “People are being ‘assisted’ every day in Canada, in nursing homes and in hospitals. We know this, everybody knows this.

“We have elderly starving themselves to death. We have situations in hospitals where the morphine is increased just that much.”

Video: Dr. Donald Low makes a plea for Canadians to legalize assisted suicide, in a video made before his own death

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While euthanasia (when someone “acts deliberately” to end another person’s life) and assisted suicide are illegal under the Criminal Code, it is up to provinces and territories to enforce the law. In 2010, a majority of MPs voted down a Bloc Quebecois bill to allow physician-assisted suicide.

Related News Oregon doctor to Quebec lawmakers: say no to assisted suicide

“We recognize the interest in dialogue, and feel provinces and territories and NGOs are more appropriately placed to engage citizens,” the briefing notes says. “For now the federal government is clear on the legal framework for these issues.”

READ MORE: Donald Low urges Canadians to legalize assisted suicide in posthumous message

The document says the issue is divisive, but shows most Canadians are in favour of the practices, citing a March 2013 Environics poll that puts 63 per cent of Canadians in favour of legalizing assisted suicide and 55 per cent for euthanasia.

A January 2012 Forum poll says support is highest in Quebec at 81 per cent and lowest in the Prairies at 60 per cent.

Ontario was most likely to raise the issue during the Oct. 4 meeting, the documents say, with Premier Kathleen Wynne and provincial Health Minister Deb Matthews publicly supporting a public debate on end-of-life issues.

But Matthews said the federal government has jurisdiction and would have to act before the province “could empower dying patients to hasten their own deaths,” and will instead focus on palliative care, the note says.

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In an emailed statement to Global News, Ambrose said: “I think we can all agree this is an emotional and divisive issue. A large majority of Parliamentarians ultimately voted not to change the law in 2010 – we will respect that decision, and have no intention of reopening this debate.”

The government has said the law exists to protect the most vulnerable Canadians.

NDP justice critic Francoise Boivin calls the Conservative position “an easy way out.”

“Canadians want to have the debate,” said Boivin. “A lot of people talk to me about palliative care – and the lack of.

“To hide behind a motion that was debated in previous Parliament is not…hearing what Canadians want to say on the matter.” Tweet This

She said she’d like to see an all-party committee dedicated to the broader issue of palliative care. The NDP recently introduced a private member’s bill to improve the quality of continuing care, as well as a motion calling for a national strategy on palliative care.

The document notes that only 16 to 30 per cent of Canadians have access to palliative care – treatment for dying people. The federal government has announced investments of just $6 million since June 2012 to support community palliative care and training front-line health workers.

Even Conservatives are divided: a resolution at the recent party convention on whether to legalize euthanasia or assisted suicide was so close it went to an electronic vote. In the end, party members voted not to support any legislation that legalizes the practice, although the resolutions are non-binding.

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Fletcher, who was paralyzed from the neck down in 1996 after his car hit a moose, agrees that society is not ready for legislation on assisted suicide.

But he says he feels “morally obligated” to talk about it. He knows first-hand that some pain can’t be controlled.

“When you’re drowning in your own phlegm, nothing can help you with that,” Fletcher said. Tweet This

“First of all we have to understand what is happening. Palliative care is happening for some, but not enough…Perhaps if we were to improve palliative care, provide more resources for those people in difficult circumstances, the demand for assisted suicide would be reduced.”

But he added, “There are cases where all the resources in the world are not going to make the situation any better.”