Assistert selvmord i Sveits 2001

Dr. Jerome Sobel som er leder for en franskspråklig dødshjelpsgruppe i Sveits forteller i en artikkel om en alvorlig handicappet kvinne han gav assistanse til selvmord. Kvinnen på 85 år hadde bodd på sykehjem siden 1965 pga. muskelsvinn, i 2001 ba hun om å få hjelp til å dø, hennes tilstand var da kommet så langt at det nærmet seg tiden hvor hun ikke lenger ville være i stand til å svelge selv.

Første møte skjedde sånn:

On 20.07.2001, I visited the community health centre to get to know this lady face-to-face. I found myself seated with a patient who was calm, lucid, coherent, bedridden and totally disabled due to a quadriplegia. This lady complained about her total dependence and the progression of her illness due to the appearance of the beginnings of diplopia and a light dysphagia. After a lengthy meeting, she confirmed to me her request for assisted suicide whilst it is still possible for her to swallow. I then had a discussion with the daughter of this patient,and the head nurse of the community health centre.

Tredje møte – kvinnen har nå gjennomgått psykiatrisk evaluering, samt hatt besøk av en prest:

On 10.08.2001, I visited the community health centre for the third time. Mrs. K. was still persistent in her request, and she told me that she had been subject to “friendly” pressure to get her to change her mind. She had been visited by a chaplain who had talked to her of sin and hell, but in vain. She had also undergone a psychiatric examination to evaluate the soundness of her judgement and the level of her depression. The outcome: no evidence of confusion.

Fjerde møte:

I went to the Hospital of Lavigny for a fourth meeting with Mrs. K. A meeting
was held between the patient, her two daughters, the head doctor of the neurology department,
and the chief nurse. The doctor confirmed that the patient was lucid, non-depressive,
and that she possessed all her faculties of judgement.
He confirmed that there was no possible curative treatment, but proposed a transfer to palliative care in another community health centre, which the patient firmly refused. She renewed her request for assisted suicide for the following day, 17 August, as planned.

17. august gir dr. Sobel kvinnen dødbringende medisin. Da sykehjemmet og senere sykehuset hun er overført til ikke vil godta at hun tar selvmord der og ingen av hennes to døtre har bolig som er passende, velger kvinnen å avslutte sitt liv i en campingvogn.

The afternoon of 17 August, I returned to the Hospital of Lavigny for a fifth visit with the patient,continued to reiterate her request, in the presence of the hospital’s head doctor and ofher two daughters. We then transported Mrs. K. to the camping car, according to her wish.After having settled her comfortably, I presented her with a drinkable solution of Pentobarbital which she swallowed herself with the aid of a straw, up to the last drop, because she did notwant to fail in her goal to depart. Mrs. K. dropped progressively to sleep, and fell slowly intoa deep coma which would result in decease.

Dr. Sobel kommenterer at helsepersonell kan føle sin faglige stolthet såret når en pasient ber om dødshjelp:

In most cases, a request for assisted suicide is viewed as a denial, as an indication of the failureof the care system. The carers must nevertheless bear in mind that the criteria for evaluatingthe quality of a life are very personal, and often have no relation to the quality of the careprovided by the health centre.

Til slutt skriver han noe om hvordan sveitsiske leger forholder seg til dødshjelp:

During the 11 December 2001 meeting of the National Council, on direct active euthanasia and assisted suicide, the Swiss Academy of Medical Sciences opposed active euthanasia.On the other hand, contrary to its previous stand, today this organisation considers that, incertain cases, assisted suicide can be considered as part of the doctor’s activities; competent,comprehensive support during the journey towards the last major step from life to death.This step is not delegated by the dying person to the doctor, but is taken by the dying personhim/herself, at his/her own free will.

De motsetter seg altså aktiv dødshjelp, men åpner opp for assisterte selvmord i enkelte tilfelle (tankegangen synes å være at ved aktiv dødshjelp er det legen som er fullt ut ansvarlig for at døden inntreffer, mens ansvaret i større grad tillegger pasienten dersom legen kun medvirker til selvmord; en holdning som er litt annerledes enn hva som er vanlig i jusen hvor det å medvirke til en handling ofte blir ansett like med å utføre den selv).


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