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Advanced cancer is one thing, he said. “For heart failure, lung disease — it can be very, very challenging to prognosticate right up to the very end.”

Other doctors said it would have been almost impossible to attempt to legislate a specific time frame, or circumstances.

“They’re specifically saying it isn’t confined to one year or two years or five years,” said Dr. Kevin Imrie, president of the Royal College of Physicians and Surgeons of Canada and physician-in-chief at Sunnybrook Health Sciences Centre in Toronto.

“It’s defined by the fact their illness is progressive, and would reasonably be expected to lead to their death in a foreseeable way.”

While the wording isn’t perfect, “it does allow us some critical latitude to say, ‘this isn’t the type of scenario that we envision requiring assisted dying,’ ” said Dr. Jeff Blackmer, vice-president of medical professionalism at the Canadian Medical Association.

Diabetic neuropathy, for example, is an exquisitely painful form of nerve damage that is very difficult to treat, Blackmer said.

“But, we know that the person is not going to die of it. We know that it’s temporary. We know that they will get through this.” On all other fronts, the person would otherwise meet the criteria for an assisted death, “except we know it’s not going to result in a downward course,” he said.

By contrast, someone with an advanced kidney condition who requires dialysis may not be terminal — they may not die within the next six months, or year — “but we know the reasonable foreseeable consequence of their kidney disease is a natural death. We know it’s headed in that direction,” Blackmer said. “That type of patient would likely qualify.”

It’s not perfect, but I think it’s an attempt at trying to find some balance

“It’s not perfect, but I think it’s an attempt at trying to find some balance,” he said.

Others say the legislative draft is brazenly restrictive and criticized the Liberals for invoking the concept of “natural” death. Queen’s University bioethicist Udo Schuklenk said the Supreme Court did not say, “Death needs to be close.” The high court only said the condition must be grievous and irreversible and causing enduring and intolerable suffering, he said.

“There is no word there that you have to be at the end of your life.”

skirkey(at)postmedia.com

Twitter.com/sharon_kirkey