El derecho a morir dignamente, ¿disyuntiva valórica o simple debate de posiciones?

Adulto mayor

3 de Abril de 2013


Esta es quizás, una de las mayores controversias que puede existir en nuestros tiempos, estamos en instancias en donde una sociedad cada día más evolucionada y mejor informada quiere formar parte de este debate, con sus posiciones a favor y en contra de lo que se ha llamado “Eutanasia”. Ya diversos países han plasmado positivamente este derecho en sus hojas legales, siendo esto de una relevancia tal, que se ha llevado hacia incluso una consagración constitucional “el derecho a morir dignamente”, argumentos esgrimidos hacia las dos posiciones hay, y de peso para poder hacer definir a una persona indecisa el camino a tomar a futuro, en el presente ensayo se abordaran las dos visiones para que al final, el autor de la misma señale su opinión personal.

En primer lugar debemos (antes de profundizar el debate) precisar en concreto ¿Qué es eutanasia?. En pro del dinamismo de esta columna, se remitirá a decir que esta palabra en su etimología significa “buena muerte” y que el concepto médico dado a él es “acción o inacción hecha para evitar sufrimientos a personas próximas a su muerte, acelerándola a sabiendas de la misma”, en definitiva es una muerte asistida voluntaria. El concepto no determina una posible clasificación, pero en la práctica esta fue determinada, son términos adoptados en el medio hispanohablante.

Existe una eutanasia directa, la cual consiste en adelantar la hora de la muerte en caso de una enfermedad incurable, determinando el alcance de este concepto, aquí se puede encontrar una sub-clasificación; eutanasia activa, que consiste en provocar una muerte indolora a petición del afectado, ejemplos claros son casos como personas que padecen cáncer terminal u otras enfermedades incurables, como la esclerosis múltiple o sida, en la cual se aplican a la persona dosis de sustancias mortíferas, o sobredosis de morfina en su caso; luego encontramos la eutanasia directa pasiva en la cual se deja de tratar una complicación, o se deja de alimentar al enfermo por mecanismos propios de la medicina (ej: Nutrientes intravenosos, suero etc) en donde se precipita el término de la muerte.

Luego, hay una eutanasia indirecta, aquí se efectúan procedimientos terapéuticos que tienen como efecto secundario la muerte, un ejemplo claro de esto es la morfina suministrada al enfermo con el objeto de apaciguar sus dolores crónicos derivados de una enfermedad terminal, en principio el efecto principal es el de disminuir la conciencia del individuo, pero con ello se conduce a un efecto no contemplado o una consecuencia indirecta, que es la muerte del enfermo.

Luego, existen otros conceptos relacionados indirectamente a la eutanasia

Suicidio asistido: Aquí se proporciona intencionalmente y con conocimiento de la persona los medios, procedimientos o ambos para suicidarse, esto puede incluir asesoramiento sobre dosis letales de medicamentos y la emisión y facilitación de estos mismos.

Cacotanasia: Es la eutanasia, sin el consentimiento del enfermo

Ortotanasia: Dejar morir, pero sin emplear medios desproporcionados y extraordinarios; aquí se actúa con medicamentos paliativos para evitar sufrimientos hasta que la muerte ocurra. Se debe señalar si, que hay una mala interpretación, respecto a que este no es un tipo de eutanasia, pues la ortotanasia se diferencia con la primera en que nunca se pretende deliberadamente el adelanto de la muerte del paciente.

Distanasia: Aquí se procura posponer el momento de la muerte, recurriendo a cualquier medio artificial, pese a que haya una convicción segura de que no se podrá recuperar la persona de la enfermedad que le afecta, todo ello con el fin de prolongar la vida del enfermo a toda costa.

Los argumentos que son a favor o en contra, tienen diversas fuentes en donde emanan, las cuales dan a entrever la transversalidad que ha tenido este tema.

Los argumentos a favor se basan en el supuesto de que el hombre es dueño de su propia vida y que como esto es así, tiene un derecho intrínseco de ponerle fin a la misma, especialmente si esta consiste únicamente en dolor y sufrimiento sin posibilidad de mejora, además se señala que con la eutanasia se adelanta  un final a esas alturas “inevitable”, lo que pone fin a una larga y triste agonía tanto del enfermo como de sus más cercanos, sin contar por supuesto el costoso tratamiento médico que conlleva mantener a la persona con vida. Desde la perspectiva medica el respeto a la autonomía de la persona y los derechos de los pacientes son cada vez más ponderados al momento de determinar decisiones médicas, lo anterior, complementado con el consentimiento informado (claridad de la voluntad del enfermo terminal de querer morir voluntariamente) y la declaración de voluntades anticipadas (figura no introducida en nuestro ordenamiento interno) son una eficiente y determinada manera de regular las actuaciones medicas frente a situaciones en donde la persona pierda ya sea parcial o totalmente su autonomía para decidir en el momento sobre actuaciones medicas pertinentes a su estado de salud, complementando lo anterior, viéndolo desde una perspectiva netamente jurídica, se señala que la sociedad moderna basa su ordenamiento jurídico en la protección de los derechos humanos, por lo tanto, siguiendo la línea anterior cada enfermo tiene derecho a decidir de manera informada sobre los asuntos que pertenecen a una esfera tan privada como su cuerpo y en virtud de esto, decidir cómo quiere seguir o no seguir viviendo.

Quienes están en contra de cualquier tipo de muerte asistida, contrargumentan que la vida es un valor de origen divino que la persona simplemente administra, pero que no posee, aquí la eutanasia pasa a ser un eufemismo para cubrir un homicidio o un suicidio dando a entender que la mejor solución es dar una muerte digna al enfermo mediante el alivio de su dolor en vida, en espera del deceso natural (cuidados paliativos), además ven a esta opción como una apertura de un espacio al oportunismo en el caso de que la muerte de la persona tenga relación directa con obediencia a intereses materiales o pecuniarios, además al señalar que la eutanasia es contra natura y contra ley, los médicos estarían contraviniendo el juramento hipocrático, lo cual es avalado por la Asociación Medica Mundial, además la mayoría de las iglesias cristianas es contraria a la eutanasia y al suicidio asistido, siendo recogido esto por el actual Papa Benedicto XVI

La tendencia legislativa nacional respecto a este tema es relativamente nueva, en comparación a otros países, en el año 2002 como parte de la Reforma a la Salud se insertó un artículo el cual señalaba explícitamente que en caso de enfermedad terminal que le cause un padecer físico insufrible podrá pedir por razones humanitarias la muerte previo acuerdo con un medico cirujano, por la polémica de esto, se retiró este articulo para evitar que esta modificación a la salud publica quede rechazada y archivada. En octubre del año 2004 se presenta al Parlamento un proyecto de ley con el patrocinio del entonces Senador Nelson Ávila con el objeto de legalizar la eutanasia, se considera tal proyecto como archivado en el congreso, y en mayo del año 2006 los parlamentarios socialistas Fulvio Rossi Ciocca y Juan Bustos Ramírez  presentaron el último proyecto de ley respecto a este tema, el cual sigue con la denominación de “tramitación” en el Congreso Nacional. En comparación con otras naciones no resulta distinta dentro de nuestro continente, pero en Europa hay 3 países que actualmente tienen legalizada la figura de la eutanasia, dos casos ejemplares son Holanda, que después de 25 años de discusión sobre el tema en el año 2002 pasa a ser legal la eutanasia y puede ser realizada bajo dos condiciones; repetida petición expresa del paciente y comprobarse medicamente que no hay posibilidad absoluta de mejorar su condición, y también en Bélgica, siendo aquí el proceso mas burocrático si se hace un paralelo con el país europeo antes señalado.

Quizás un caso ejemplar de este llamado “Derecho a morir” es el del español Ramón Sampedro, quien a los 25 años queda tetrapléjico luego de saltar desde un acantilado en la Península Iberica, Sampedro totalmente lucido empieza una batalla legal para que los tribunales lo autorizasen a “morir dignamente”, esto resulto infructuoso sin resultados positivos, ante esto optó por suicidarse con cianuro de potasio, implantando un plan para que ninguno de quienes intervinieron fueran imputados por ello, grabando un video eximiendo de responsabilidad a todos ellos, para posteriormente suicidarse. Esta historia fue recogida por el director español Pedro Almodóvar en la película “Mar Adentro”.

Luego de ver tanto aspectos positivos, y negativos respecto a esta llamada “teoría de la muerte digna”, he podido señalar que si bien cada persona tiene derecho a vivir dignamente, también tiene ese mismo derecho para morir de manera digna y sin dolor alguno o en su caso, evitando el mayor dolor posible tanto para la persona afectada como para los seres queridos de el mismo. Hemos adquirido una mayor conciencia respecto a un tema tan delicado como la calidad de vida, pero he aquí la pregunta que quizás radica todo ¿La calidad de vida conlleva en si mismo la calidad en la cual cesa esta?, para el autor de esta columna después de lo anteriormente señalado, la respuesta es totalmente afirmativa, aquí no se busca la muerte de la persona por compasión, pena o algo similar, se busca simplemente revestir un acontecimiento como la muerte de una persona en determinadas circunstancias corporales, como una muerte digna, sin ataduras de una desidia institucional que aboga por un derecho a la vida del que está por nacer, pero que no defiende la voluntad del que esta por fallecer. Vivir es un derecho, pero para estas personas, el vivir pasa a ser totalmente lo contrario, pasa a ser una obligación, una que resulta inviable para ellos, en estos casos no solamente hay  “duda razonable” (si se quiere hacer una analogía general con un aforismo penal) en estos casos, sino que estamos en presencia de una “petición razonable”. Hemos de recordar siempre que los Derechos Humanos deben ser interpretados de manera amplia, no solamente a hechos determinados como ha sido la tónica de estos últimos años, la humanidad conlleva en si la posibilidad de disponer de nuestro cuerpo, esto sea para donar órganos en caso de una muerte accidental o definir como seria nuestra muerte en caso de sufrir alguna enfermedad terminal, no hay doctor ni juez que debiera determinar el como disponer del cuerpo de una persona determinada en sus últimos días.

 

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