Nútená liečba: Teraz sú na rade sudcovia | Medicínske právo
              

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Nútená liečba: Teraz sú na rade sudcovia


 | 6.8.2013 | komentárov: 411

V nemeckej spolkovej krajine Sasko existuje právna medzera v nútenej liečbe pacientov. Teraz majú sudcovia v každom jednotlivom prípade schvaľovať nútenú liečbu.

Obrazok Lekári v Sasku kritizujú právnu neistotu pri liečbe psychicky chorých. Delegáti lekárskej komory vyzývali prednedávnom Krajinské ministerstvo zdravotníctva na prijatie aktuálnej a praktickej zákonnej právnej úpravy pre liečbu psychicky chorých. Vo februári tohto roka rozhodol Spolkový ústavný súd v Karlsruhe, že saský zákon pre psychicky chorých nie je v súlade so Základným zákonom (pozn. Ústavou) SRN. Ústavný súd kritizoval najmä časť zákona, ktorá v Sasku doposiaľ umožňovala vykonávanie nútenej liečby aj proti vôli pacienta. Posúdenie lekára bolo rozhodujúce pre nariadenie liečby, a to v prípade  „ak odkladom liečby mohol byť život alebo zdravie pacienta závažne ohrozený.“

Spolkový ústavný súd navrhuje prísnejšie pravidlá

Spolkový ústavný súd vyhlásil aj saskú právnu úpravu nútenej liečby za protiústavnú a tým čiastočne za neplatnú. Súd rozhodoval v prípade muža, ktorý trpel chronickou paranoidnou schizofréniou a odmietal užívať ďalšie neuroleptiká (pozn. liečivá, psychofarmaká, používané predovšetkým pri liečbe psychotických porúch). Ošetrujúci lekári napriek vôli pacienta nariadili podávanie týchto liekov. Zákonný zástupca psychicky chorého súhlasil. Ústavný súd vo svojom rozhodnutí konštatuje, že súhlas zákonného zástupcu psychicky chorého pre nariadenie nútenej liečby nie je postačujúci.

Nie je to však prvýkrát, čo sa Spolkový ústavný súd zaoberal skúmaním ústavnosti právnej úpravy nútenej liečby. Aj v roku 2011 vyhlásil právnu úpravu spolkových krajín Rheinland-Pfälz a Baden-Württemberg za protiústavnú. Podľa vyvstávajúcich právnych princípov musia lekári a súdy akceptovať, ak sa pacient vedome rozhodne proti liečeniu.

Oznámenie a kontrola nevyhnutná

Iba v prípade, ak pacient v dôsledku choroby nie je schopný sám rozhodovať, môže byť nariadenie nútenej liečby oprávnené. Predpokladom je, že pacient ohrozuje seba alebo iných. Nevyhnutné je k tomu oznámenie o liečení a nezávislá kontrola; súd poukazuje, že za nezávislú kontrolou sa nepovažuje súhlas zákonného zástupcu. Tieto predpoklady v Sasku doposiaľ neboli splnené. Ústavný súd ďalej upozorňuje, že v saskej právnej úprave navyše chýba ustanovenie cieľa, pre ktorý má byť nútená liečba prípustná.

Nútená liečba= Ultima ratio

Nedávno vyzývala aj Etická komisia Spolkovej lekárskej komory, že nútená liečba by mala byť poslednou možnosťou. Takto to vidí aj politika. Začiatkom tohto roka schválil Spolkový snem a Spolková rada Zákon pre úpravu právneho súhlasu pre lekárske donucovacie opatrenia, ktorým sa mení ustanovenie § 1906 Občianskeho zákonníka. V novej právnej úprave zákonodarca upravuje podmienky, za ktorých môže byť osoba aj proti jej prirodzenej vôli lekársky liečená:

-    Ak takáto osoba z dôvodu svojho ochorenia nemôže rozpoznať nevyhnutnosť lekárskeho opatrenia
-    Ak bol predtým zákonný zástupca presvedčený o nevyhnutnosti lekárskeho opatrenia
-    Ak je nútené opatrenie nevyhnutné pre odvrátenie hroziaceho poškodenia zdravia
-    Očakávané prínosy lekárskeho núteného zákroku jasne prevážia nad očakávanými stratami  
-    Ak súd schválil nútené opatrenie

Spracovala:  Lucia Onderková
Foto: freedigitalphotos.net

Zdroje:


http://www.aerztezeitung.de/politik_gesellschaft/medizinethik/article/835372/zwangsbehandlung-verfassungsgericht-fordert-strengere-regeln.html
http://www.aerztezeitung.de/politik_gesellschaft/medizinethik/article/842870/zwangsbehandlung-jetzt-muessen-richter-ran.html?sh=10&h=-711972454
http://www.aerztekammer-berlin.de/10arzt/30_Berufsrecht/10_Gesetzesaenderungen/56_Betreuungsrecht.html




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