The Roman Catholic Diocese of Raleigh came out strongly Tuesday against proposed legislation aimed at strengthening patients' control over the care they want at the end of life.

The bill, developed over three years, revises the ways that patients in North Carolina can give a trusted person legal power over medical decisions. In addition, the bill contains a more far-reaching medical document than the current "do not resuscitate" form. It's designed to alert doctors and others to the measures a patient wants taken -- or not taken -- if death is near.

A spokesman for Bishop Michael Burbidge, however, told a legislative hearing Tuesday that the bill needs more work because it "deals with issues that we believe have eternal consequences."

"Our concern is that we'll move more toward a state where euthanasia becomes a common practice," spokesman Msgr. Michael G. Clay said after Tuesday's hearing.

The bishop's involvement comes at a time when the bill had been heading through the General Assembly with some opposition from N.C. Right to Life, but also with significant backing from the powerful groups that helped craft it: the State Bar Association and the N.C. Medical Society. But Burbidge's involvement is in keeping with issues he has emphasized since becoming bishop of the diocese in August. Since his installation, he has frequently spoken against abortion, stem cell research and euthanasia. In January he marched in an anti-abortion rally in Washington, and he also has written to church members opposing embryonic stem cell research.

Dr. Darlyne Menscer, the Charlotte physician who is president of the N.C. Medical Society disagreed with the diocese's view on the end-of-life issue.

"Physicians are reluctant" to forgo treatments, Menscer said, but yield when patients' views are clear. "They are not looking for an opportunity to limit care."

The "advance directives" bill got a positive recommendation from a Senate Judiciary committee in spite of Clay's statements against it. It now goes next to the Senate floor.

The legislation arose out of a process involving the medical society, the State Bar Association and other groups who said North Carolina's end-of-life documents -- including health-care power of attorney, living will and do-not-resuscitate orders -- are confusing, contradictory and outdated.

Prolonging life

Melanie Phelps, associate general counsel for the medical society, said the group asked the diocese to become part of the process more than a year ago. But the diocese was in transition between the retiring bishop and Burbidge.

Apologizing to committee members for being "Johnnies come lately," Clay said the church now hopes to become part of crafting a bill that falls on the side of prolonging life.

"The bill is leading us more in a direction where the bias is really towards terminating life, with a diminution of options for choosing life," Clay said. "For example, they have changed the language from 'life-sustaining measures' to 'life-prolonging measures' and that language itself we think speaks philosophically to a shift in focus of health-care for those at the end of life."

MOST forms

Proponents of the legislation argue that provisions allow people to express many different preferences for end-of-life care. Included in the bill is a new form -- called MOST, for "medical order for scope of treatment" -- that is similar to documents used in some other states. The form is not required, but if filled out would let patients request that doctors refrain from administering cardio-pulmonary resuscitation, antibiotics, medically administered fluids and nutrition, and other options. On the other hand, patients or their representatives can specify that they want every possible intervention to be kept alive.

"The MOST form allows you to say explicitly that you do not want to limit anything," Menscer said.

(Yonat Shimron contributed to this report.)