Select Committee on Assisted Dying for the Terminally Ill Bill Minutes of Evidence


Examination of Witnesses (Questions 2340 - 2359)

THURSDAY 3 FEBRUARY 2005

PROFESSOR WOLFGANG HOPFF, DR HANS-R NA­EGELI, MR LUDWIG MINELLI, MRS SORAYA WERNLI, MR SILVAN LULEY and DR PETER REINHARDT

  Q2340  Chairman: Your collaborator is there?

  Mr Minelli: Yes, and also relatives normally.

  Q2341  Chairman: Is the collaborator a person with any particular qualifications?

  Mr Minelli: The qualification must be that he has a lot of empathy with other people, that he is on the same line as we are, first to help towards life if it is possible, and therefore also our collaborator tells the person, "You have the liberty to leave if you would like", and he must be very reliable. He must do his work exactly like we have instructed him. These are the main qualifications we need.

  Q2342  Chairman: Is he paid for that?

  Mr Minelli: He is paid 500 Swiss francs for every accompaniment.

  Q2343  Chairman: You do not normally have a doctor present at that stage?

  Mr Minelli: The doctor is not present. The doctor is perhaps there or in his office but in the apartment the only assistant is the accompanier. The doctor is not present.

  Q2344  Chairman: The doctor makes a prescription for the barbiturates?

  Mr Minelli: He makes a prescription for 15 grams of pentobarbital of sodium.

  Q2345  Chairman: Has the doctor seen the patient before?

  Mr Minelli: Of course.

  Q2346  Chairman: He comes to the apartment to see the patient?

  Mr Minelli: To the apartment or the patient goes to the doctor.

  Q2347  Chairman: And it is at that stage that the prescription is given?

  Mr Minelli: Yes.

  Q2348  Chairman: What happens next? Does the collaborator come and collect the prescription? How does it work?

  Mr Minelli: Sometimes we have prescriptions with the addendum "Primopraxi" and with this we can get the pentobarbital, so we have a reserved portion. We take this reserved portion and afterwards with the prescription we go to the pharmacy and look for a new one.

  Q2349  Chairman: I see. You have got a kind of reserve that you keep up to date with the prescription if you have to take some out for a particular patient? Is that right?

  Mr Minelli: Yes, normally we have a reserve.

  Q2350  Chairman: Do you keep that at the apartment?

  Mr Minelli: No. The companion or collaborator will have the reserve. We never hand out the pentobarbital. We always prepare it in a glass of water. We give it to the member. If the member leaves it is put away. If the powder is not yet dissolved we take it back. We never hand it out because we have to guarantee to the state that there is no misuse with pentobarbital. On the other hand, we have to guarantee to our member that we may help him.

  Q2351  Chairman: And then, as you mentioned, it may be that your organisation will be responsible for the arrangements following the death and if you are there is an additional arrangement for that?

  Mr Minelli: Yes.

  Q2352  Chairman: That will include the return of the body to the home or to have cremation or whatever?

  Mr Minelli: Following the instruction we get from the patient.

  Q2353  Chairman: All that is in documentation before the assistance takes place?

  Mr Minelli: Yes.

  Q2354  Chairman: Can you tell us a little bit more about the nature of your organisation? What is the structure of the organisation?

  Mr Minelli: The structure is very simple. We have different categories of members. We have two active members and therefore no power struggle is possible. We have always to agree. One of the active members is the husband of Mrs Wernli, an old friend of mine, and the other is myself. We two are the General Assembly. We take the basic decisions and as the General Secretary I have to execute these decisions. Our members from all over the world have no member rights, no voting rights, because we have seen that the voting rights of other members may come to a power struggle in a general assembly of 700 or 800 people and we wanted to avoid such a situation. Then we have the board of Professor Hopff and the lawyer Dr Egli. They counsel the General Secretary. If I have a specific question where I cannot find the solution myself I will ask the members of the counselling board.

  Q2355  Chairman: Can you give us an example of where you have sought their advice?

  Mr Minelli: At the beginning of our activity we discussed the question whether or not it would be possible to help mentally ill people.

  Q2356  Chairman: What was the conclusion?

  Mr Minelli: The conclusion was that if somebody with mental illness has capacity of decision he has the right to an assisted suicide, but of course we would never hasten the death of a mentally ill person. We will try to be sure that there is no other solution possible, so normally if somebody with a mental illness is helped he has been ill for 10 or 15 years before and has tried a lot of different therapies and had no positive effect.

  Q2357  Chairman: So if a member from your ordinary membership comes along and he sees the doctor with a view to having a prescription but the doctor considers that his mental state is at least doubtful, what happens then?

  Mr Minelli: Then we will ask a second doctor, perhaps a specialist, a psychiatric physician, because we would in any case avoid helping a person who has no capacity of decision or where capacity of decision is doubtful.

  Q2358  Chairman: Are the doctors that give the prescription or to whom such a reference is made, part of your organisation? What is the connection between your organisation as you have described it so far and the doctors who do the prescribing or who may be asked to examine a patient from the point of view of that patient's competence?

  Mr Minelli: The doctor is completely independent from us. We are always looking to see if we can find physicians willing to collaborate with us and fortunately we find sometimes a physician who accepts the responsibility of the back side of the medal of modern medicine and tells us, "Yes, I will help because I know that modern medicine, modern hygiene, are causing a lot of pains when people are in old age".

  Q2359  Chairman: If a member is applying for help do you refer them to one or other of these doctors?

  Mr Minelli: Yes.


 
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