Dr. Kenneth McElynn, vice president of the Catholic Medical Association, spoke to the state House health committee against a bill that would retool the state's laws on end-of-life care.

Passage of the bill, which the committee voted to move forward Tuesday, could lead to "back-door euthanasia" in the financially stressed health care setting, said McElynn, a Cumberland County public health consultant.

"In this environment, the right to die with dignity often becomes the duty to die outside an expensive hospital," he said in a statement that he read and distributed.

McElynn would not disclose the number of doctors represented in the state's Catholic Medical Association, calling the information "proprietary."

Representatives of hospice, medical and nursing home groups rejected McElynn's statements and expressed support for the proposed legislation.

"I am very surprised to hear this stance on it," said Polly Welsh, a director with the N.C. Health Care Facilities Association. She added that the bill is "a continuing attempt to make sure that people have a mechanism to make choices and that they can clearly communicate them."

The bill includes a new, optional medical form called MOST, for Medical Order for Scope of Treatment. It would let patients or their representatives tell doctors in advance not to use specific medical treatments -- or to use every possible means to prolong life.

"We believe that those who promote and support this bill are well-intentioned," McElynn said after the hearing. "We are interested in being reasonable and working to craft a better bill that protects the vulnerable, the elderly and the mentally infirm."

The bill, which would also revise the state's language on health care power of attorney, passed the Senate in May and moved forward on a voice vote Tuesday. Sen. Fletcher Hartsell, a Concord lawyer, told committee members the bill represents the efforts of North Carolina lawyers, doctors, social service workers and others with an interest in end-of-life care.

"What we have before us has taken at least 2 1/2 years to get here," Hartsell said.

Several steps remain before the measure could become law, including continuing negotiations with the Roman Catholic Diocese of Raleigh, which has voiced concerns.

"We're not opposing it, but we are not ready to support it either," said Monsignor Michael Clay, representing Bishop Michael Burbidge.

Clay has been working with bill framers and urging legislators since May to take more time on it. At that time, Clay described euthanasia as a possible outcome if the bill passes. Asked later about McElynn's comments, Clay said he could not address them directly.

"I'm not a doctor; I don't work in a hospital," he said. "I couldn't speak to that day-to-day reality."

During his testimony to the House committee, McElynn attempted to compare potential abuses of the proposed law to another chapter in North Carolina's past, when forcible sterilization was required of thousands who had been deemed unfit or infirm.

At that point, committee Chairman Rep. Bob England, an Ellenboro doctor, cut off McElynn's presentation.