Our new associate member MTÜ Kodanik gives an overview of what is happening in Estonia
The Estonian developments were initiated by the NGO Kodanik, which promotes civil rights, and whose representative Paul Tammert’s grandmother waited in her bed for 4 years, and then the mother, who also waited for 3 years and demanded an explanation from her son why he could not die of his own free will.
Seeking legal clarity
To get an answer to this question, the organization first turned to the Police and Rescue Board, whose representative stated that “if an elderly person dies without signs of violence, then it is not their issue”.
The Minister of Social Affairs refused to answer the officially submitted question, but in the end the Head of one of the Departments stated that “We only deal with health, and death is not our business!”.
The question submitted to the State Prosecutor’s Office was answered that “assisted dying is prohibited in Estonia!”. However, when the NGO was asked to refer to the legal basis for the submitted claim, it was unable to answer anything and was asked to turn to the Ministry of Justice.
Previous public discussions on the topic of assited dying, between politicians and public figures, invariably ended with the conclusion “We are not ready for such a decision yet!”
Citizens’ initiative
Since Paul had an engineering education and also knowledge of the field of human physiology, he put together a device that used helium and allowed the person who wanted to end their life of their own free will. After it was introduced in the public media for provocative purposes, people who wanted the service immediately appeared. Since there was no legal obstacle, there was no reason to refuse to provide such a service, although it was not originally planned. The service included:
- Counseling on end of life choices;
- Rental of a device suitable for performing an asssited death.
After two successful uses of the equipment, the third failed and this caused a conflict between relatives, which ended with the police being called. On this basis, the State Prosecutor’s Office initiated proceedings, which ended with the criminal prosecution of Paul Tammert, not the NGO Kodanik that provided the service.
The basis of the charge was the provision of an unlicensed service without the required permit. The State Prosecutor’s Office essentially incriminated the commission of the crime with the claim that the service provided complied with the provisions of the Health Services Organization Act. The basis for the justification of the claim was the facts that: - A regular electrical panel purchased from a store – on which an alarm button to start the process, a choke and a time relay were installed – is a medical device according to the law;
- Helium – which does not react with anything – is a therapeutic gas;
- The precondition specified in the service provision agreement that
• the service is provided only to elderly people whose life is coming to an end was considered a geriatric service provided for by law;
• the service is provided only to people suffering from an incurable disease meant performing a medical examination and assessing the person’s mental state, which can only be done by a clinical psychologist. - The motive for providing the service was to earn profit.
Court proceedings
The County Court found the evidence presented by the State Prosecutor’s Office to be in accordance with the law and found that P.T. was guilty of committing a crime and sentenced him to 1 year of suspended imprisonment, with a two-year probationary period.
The decision was appealed to the Circuit Court, which upheld the first decision, but noted 7 times in its decision (Sic!) that if an official says: “You can’t”, then you can’t… comment: even if the law does not give you the right to do so.
Unfortunately, the Supreme Court did not take a position on the Circuit Court’s claim, but overturned the County Court’s conviction, because the State Prosecutor’s Office was unable to present the section under which Paul Tammert and MTÜ Kodanik were found guilty, nor to prove the claim that Tammert acted out of self-interest.
Note: The fee paid for the service remained on the account of the MTÜ and was used to cover the costs arising from the provision of the service, not a single cent was credited to P.T.’s account, either directly or indirectly.
Further developments
It is currently unclear what the future holds. Leading politicians and officials have expressed their deep disappointment with the Supreme Court’s decision and have been unable to decide how to proceed.
Since the start of the process, a legal provision on “end-of-life declarations” was adopted – after several years of proceedings – which gives a person the right to refuse resuscitative treatment, it is hoped that this will be enough. Politicians also emphasize that the Government is increasingly contributing to the costs of nursing homes and hospices, although neither of them has enough money to cover the actual needs.
The NGO Kodanik is also planning its further activities in this area and is looking for cooperation opportunities with corresponding organizations in other countries
To contact MTÜ : tammertp@proton.me