von Lisa Zwirchmayr
Im Jahr 2019 suizidierten sich in Österreich 868 (78%) Männer und 245 (22%) Frauen (n=1113). Im Vergleich hierzu mussten im selben Jahr im Straßenverkehr 416 Personen ihr Leben lassen – eine deutliche Senkung dieser Zahlen wird durch die Investition von Staatsgeldern in den Ausbau des Verkehrsnetzes sowie in eine Allgemeine Förderung der Verkehrssicherheit möglich [1]. Ein Antrag vor dem Verfassungsgerichtshof machte es im Juni 2020 möglich, dass nun auch der „Freitod“ in Österreich näher beleuchtet wird.
Die Regierung hat sich mit 23.Oktober nun auf eine Neuregelung der Sterbehilfe im Rahmen einer Sterbehilfeverfügung geeinigt – das Präparat „Natrium-Pentobarbital“ soll in der Apotheke verfügbar sein, und, oral eingenommen, zum Tode in den eigenen vier Wänden führen. Möglich wird dies im Rahmen einer Sterbeverfügung sein, welche im Zuge einer unheilbaren, mit großem Leiden verbundenen Krankheit, 12 Wochen vor geplantem Ableben bescheinigt von zwei unabhängigen Ärzten ohne Einflussnahme auf den Antragsteller/auf die Antragstellerin erfolgen muss. Eine Notarin/ein Notar bzw. eine/ein rechtskundiger Mitarbeiter*in der Patientenvertretung sind berechtigt, ein solches Dokument zu errichten. Detaillierte Informationen hierzu finden sich im Bundesgesetz über die Errichtung von Sterbeverfügungen (Link anbei). Aushändigen darf die Apotheke das tödliche Präparat auch an eine, im Vorhinein festgelegte, Vertrauensperson bzw. an einen apothekenanhängigen Lieferdienst, welcher eine Hauszustellung durchführt [2].
Das Thema Sterbehilfe und Freitod wurde die letzten 1,5 Jahre von allen denkbaren Ober- und Unterseiten beleuchtet – ethisch, soziodemographisch, gesellschaftspolitisch, medizinisch, juristisch, von Seiten der Betroffenen und auch wirtschaftlich. Kaum eine Geisteswissenschaft hat sich, im gesellschaftlichen sowie politischen Diskurs, nicht diesem Thema angenommen, Glaubens- und Religionsgemeinschaften sowie Interessensvertretungen diverse Positionspapiere veröffentlicht, internationale Expert*innen diesbezüglich konferiert – Conclusio: ein polarisierendes Thema, welches mindestens so viele Facetten wie Menschen auf der Erde hat. Faktum ist aber auch, dass eine Berufsgruppe, welche direkt in der Patientenversorgung stark von dieser Thematik betroffen ist, sichtbar kein Wort darüber verloren hat – die Gesundheits- und Krankenpflege.
Eröffnet sich für die Patient*innen/Klient*innen ein neuer „Behandlungspfad“ sollte man doch meinen, dass eine Profession es wert findet, ein Wort darüber zu verlieren – sollte man, muss man aber nicht.
Nach monatelangen Recherchen, einer Diskussionssendung mit namhaften Expert*innen (Wie gesellschaftspolitisch darf Sterben sein? - Liberalisierung der Sterbehilfe) und dem nun vorliegenden (vorläufigen) Bundesgesetz, welches am 1. Jänner 2022 in Kraft treten wird, bleiben zahlreiche Fragen offen.
Wie soll im häuslichen Setting sichergestellt werden, ob und wie die gesamte letale Dosis eingenommen wurde? Diskriminiert dieses Bundesgesetz nicht alle Betroffenen, welche zur oralen Einnahme nicht mehr im Stande sind? Oder aber auch all jene, welche nichtmehr mobil sind und über kein ausreichend ausgeprägtes soziales Netzwerk verfügen, um eine Verfügung erstellen zu können? Wäre ein ärztlich assistierter Suizid nicht besser kontrollier- und monitierbar? Wie wird die Entscheidungsfähigkeit/der freie Wille der Betroffenen sichergestellt, bewertet und überhaupt erhoben? Ist man im Angesicht des Todes überhaupt entscheidungsfähig oder nicht immer von Angst, Schmerzen und Ungewissheit fremdbestimmt? Wie hat das weitere Behandlungsprozedere stattzufinden, wenn der Versuch der Selbsttötung nicht gelingt? Müssen dann im Rahmen der verpflichtenden Hilfeleistung (§ 95 StGB) lebensrettende Maßnahmen vor Ort eingeleitet werden?
Zahlreiche Recherchemonate lassen leicht optimistische Tendenzen in Richtung Selbstbestimmung, auch am Lebensende, erkennen – aber wie es mit dem Tode und der fraglichen Unendlichkeit schon immer war, hinterlässt auch diese Thematik eine gehörige Portion Ungewissheit.
Diskutieren Sie mit – Welchen Standpunkt sollte die Profession Pflege in diesem Diskurs vertreten? Kann man hierbei generalisierte Aussagen treffen, oder ist ein (gerechtfertigter) Sterbewillen in jedem Fall kontextabhängig? Welche Fragen werden sich diesbezüglich in Zukunft in der Versorgungslandschaft in Österreich stellen?
Wir freuen uns auf Ihren Input.
Quellen:
[1] Suizid und Suizidprävention in Österreich - Bericht 2020, Bundesministerium für Soziales, Gesundheit, Pflege und Konsumentenschutz
[2] https://fachinfos.parlament.gv.at/politikfelder/arbeit-soziales/warum-wurde-das-verbot-der-beihilfe-zum-suizid-vom-vfgh-aufgehoben-und-wie-ist-sterbehilfe-in-ausgewaehlten-staaten-geregelt/
Fachinformationen Republik Österreich/Parlament
https://fachinfos.parlament.gv.at/politikfelder/arbeit-soziales/wie-wird-in-oesterreich-ueber-sterbehilfe-diskutiert/
https://fachinfos.parlament.gv.at/politikfelder/arbeit-soziales/warum-wurde-das-verbot-der-beihilfe-zum-suizid-vom-vfgh-aufgehoben-und-wie-ist-sterbehilfe-in-ausgewaehlten-staaten-geregelt/
APA-OTS- Presseaussendung: Beihilfe zum Suizid ab 2022 zulässig – Was nun?
https://www.ots.at/presseaussendung/OTS_20210421_OTS0144/beihilfe-zum-suizid-ab-2022-zulaessig-was-nun
Begutachtungsentwurf – Bundesgesetz über die Errichtung von Sterbeverfügungen
https://www.ris.bka.gv.at/Dokument.wxe?Abfrage=Begut&Dokumentnummer=BEGUT_COO_2026_100_2_1907048
Am Schauplatz Gericht – Letzte Entscheidung (18.04.2021)
https://www.youtube.com/watch?v=qN4Nu0yLx94
Lisa Zwirchmayr, BSc MSc, ist Gesundheits- und Krankenpflegeperson im Bereich der Kinder- und Erwachsenenintensivpflege sowie Content-Creator für das pflegenetz. Sie beendete 2016 das Bachelorstudium Gesundheits- und Krankenpflege und ist seit 2020 Absolventin des Master-Studienganges Angewandte Gesundheitswissenschaften der IMC Fachhochschule Krems.
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Ich unterstütze auf jeden Fall Sterbehilfe zu leisten wenn es keine adäquate Behandlung die zu einer Besserung des Gesungheitszustandes führt. Diese Möglichkeit sollte auch für Personen gegeben werden die zu Hause betreut werden u von einem Arzt unterstützt u durchgeführt wird, es sollte keinem Menschen langes u unzumutbares Leiden zugemutet werden
Der Gesetzesentwurf ist ein Etappenerfolg für die bessere Respektierung des individuellen Selbstbestimmungsrechts, für die Wahlfreiheit am Ende des Lebens und vor allem für mehr Menschlichkeit in Österreich!
Auch wenn das Gesetz noch nicht beschlossen wurde, allein der nun endlich vorliegende – leider ohne Bürgerbeteiligung erarbeitete – Entwurf des Sterbeverfügungsgesetzes ist ein großer Schritt vorwärts.
• http://www.ris.bka.gv.at/Dokument.wxe?Abfrage=Begut&Dokumentnummer=BEGUT_COO_2026_100_2_1907048
• https://orf.at/stories/3233892/
• https://www.ots.at/presseaussendung/OTS_20211023_OTS0028/die-oeghl-begruesst-geplantes-sterbeverfuegungsgesetz-grundsaetzlich
• https://wfrtds.org/austrian-government-presented-assisted-suicide-bill/
Dank des weisen Urteils des Österreichischen Verfassungsgerichtshofes und des Katalysators „Sterbehilfebewegung“ wird nun endlich die palliativmedizinische Versorgung der Bevölkerung bedarfsgerecht finanziert und ausgebaut werden.
Der Gesetzesentwurf ist gut, da er mutmaßlich 80 % aller Problemfälle lösen wird.
Für die restlichen 20 % werden wir uns weiter engagieren.
Und es wäre sehr hilfreich, wenn sich die Gesundheits- und Krankenpflege mit praktischen, weniger weltanschaulichen, Beiträgen in dies Diskussion einbringen wollte.