Darren Blythe had just been given a new lease on life when he was diagnosed with stage four bowel cancer.

The 56-year-old had recently remarried the love of his life and mother of his children, Darlene, after 22 years of being apart. He had been blessed with a new grandchild and was about to retire.

He had much to live for and fought hard against the cancer that ailed him – undergoing emergency surgery and chemotherapy, though unsuccessfully. When the cancer, metastasized into his pelvis, legs, back and ribs and his condition was deemed terminal he planned a trip with his wife, planning to enjoy the last six to nine months of his life.

But that time too was cut short. A follow-up X-ray a month later to deal with complications related to his bowel resection showed that the cancer had aggressively spread to his lungs and was “peppered” throughout his body.

“Now we’re told, two to three months,” said Darlene.

Still he joked every day. A veritable “goofball” – the “comic relief” at work and at home – he told his wife he had been born with a lifetime of jokes and he wasn’t going to waste a single one of them.

But he also suffered. A lot, said Darlene.

He would wake up screaming from sedation, which didn’t last more than an hour, and lost the use of his limbs.

His organs started shutting down about five weeks after the final prognosis and his urine turned black, but there was nothing Darlene, his primary caregiver, could do but sit by his side and administer the pain medication.

“If he was going to have to go and it was going to be as awful as it was, I’m glad it took him fast. No one should have to suffer like he did. I don’t understand when someone is dying, how the issue is still about life and death,” said Darlene.

She couldn’t help but feel that the system had failed her husband, both in life and in dying. “The last thing I wanted was my husband to die, but he should have had the right to choose,” said Darlene, who has since joined Dying with Dignity’s Edmonton chapter.

Physician-assisted dying has become one of the most critical social issues of the 21st century in Canada.

Twenty years ago, Sue Rodriguez made headlines when she asked: “Whose body is this? Who owns my life?” after being diagnosed with Amyotrophic Lateral Sclerosis and wanting to make to sure she could get aid in dying when the suffering became unbearable. But it was not until February 2015 that the courts ruled in favour of a person’s right to exercise control over death.

The Supreme Court struck down the section of the Criminal Code that made it illegal to help in the suicide of a person suffering from a “grievous or irremediable” condition and gave the federal government one year to draft legislation that would allow for physicians to assist patients to die under certain circumstances.

Last Monday an expert advisory group released a set of 43 recommendations to help guide provincial, territorial and federal governments in crafting the legislation that would allow for physician-assisted dying to become part of a continuum of care for Canadians who are reaching the end of their lives.

The recommendations cover everything from safeguards, to the role and responsibilities of individual physicians, as well as institutions, to the oversight process to education and training.

Dying with Dignity was pleased with the balance struck in the report, saying the advisory group was successful in reconciling many different viewpoints and managing a wide range of concerns.

“The advisory group had both proponents and opponents of assisted dying so you can see how they’ve been quite creative in finding solutions that will work for all parties,” said CEO Wanda Morris.

Most importantly, the group put the rights of the patient at the forefront of its recommendations, she said, by ensuring that physicians inform patients about the end-of-life treatment and that if they do not offer physician-assisted dying themselves, that they transfer the patient’s care to another willing facility or doctor.

Morris said this will hopefully appease physicians who felt that referrals were a complicit act in a process they did not agree with, while ensuring that a patient who chooses physician-assisted suicide is not abandoned by the health-care system.

She is also pleased with the way the advisory group handled the issue of faith-based institutions.

There was mounting concern about the way faith-based institutions would handle the end-of-life procedure, especially as Covenant Health made it clear this fall that they would not be offering the treatment.

The recommendations state: “Faith-based institutions must either allow for the assessment and provision of physician-assisted dying within the institution or make arrangements for an effective transfer of the patient to a non-objecting institution.”

When asked for a reaction to the recommendations as they pertain to role of faith-based institutions, Covenant Health replied that it was too early to comment.

“Given that the final report details a series of recommendations … it is premature to comment on the report until we know what the actual legislative and regulatory frameworks will be governing the practice of hastened death in Alberta,” said Dr. Gordon Self, vice-president of mission, ethics and spirituality at Covenant Health, in a written statement.

Alberta Health also declined to answer specific questions on the recommendations, but offered the following statement on behalf of the minister, Sarah Hoffman: “It is important that we review the available research and speak with Albertans, before we make any definitive decisions on particular recommendations, but I can say that we will work with faith-based and public institutions to ensure an effective and respectful process.”

Karen Richert, a member of Edmonton Prolife, said the perception that the recommendations paves this “great middle road that everybody will be happy with” is false.

She said that the report does not alleviate the concerns of the pro-life community — the biggest of which is the creation of a duty to die.

“We’re basically saying that we’re placing a certain value on certain human life. If you’re young and requesting suicide (on a hotline) we need to put some supports in for you, but if you’re old, sick, dying, depressed or disabled we should just inject you,” said Richert, who is worried that the safeguards are nothing more than “straw houses” and that decisions will be made in favour of euthanasia based on dollars and cents given Canada’s overburdened health-care system.

More people in Canada are over the age of 50 than under.

“Make no mistake there will be a duty to die,” she said.

Darlene understands these concerns, and respects individual doctors’ decision to conscientiously object to administering the treatment, but after watching her husband suffer she cannot accept that the “most important question” about end-of-life – when to die and under what conditions – was not included in her husband’s directive.

“People can’t be abandoned. People can’t be left to starve themselves. It’s borderline cruelty. We’re doing this to protect the sanctity of life, but how are we doing that when we’re causing unbearable suffering and pain?”

In Quebec, the practice of physician-assisted suicide was made legal Dec. 10.

The Supreme Court will make a decision on whether or not to grant the Liberal government an extension of six months, during an oral hearing in January.