Norway attacks: First-aid worker acted as a human shield to save youths from gunman

Hanne Fjalestad, 43, a first-aid worker, was one of 69 people to lose their lives during the shooting at a Labour Party youth retreat on the Norwegian island.

Anders Breivik has admitted to the killings, as well as causing the death of eight more in a bombing in Oslo, but has denied murder, claiming he was defending Norway against the spread of Islam.

His lawyer has suggested he may be insane; however, that appeared an unlikely defence last night, after Dr Tarjei Rygnestad, head of the Norwegian Board of Forensic Medicine, said Breivik seemed to have been in control of his actions.

Mrs Fjalestad's story has emerged among the harrowing tales of the many young lives lost on 22 July.

She is said to have spent the last minutes of her life trying to shield youngsters from Breivik after being separated from her own daughter.

Survivors said she used her own body as a human shield, gathering groups of children behind her time and again.

Then when Breivik came at them shooting she ran heroically straight at him, making herself his target. Both Fjalestad and her 20-year-old daughter Anna were working as first-aid medics on the island. Anna survived the killing spree, but she lost track of her mother and her mobile phone in the chaos of the hour and a half-long nightmare.

"I looked for her, but I could not see her," she said.

It was her grandfather, Per Balch Sorensen, who confirmed his daughter's death: "She was found in a hospital in Oslo. She had been shot."

Mrs Fjalestad married a Norwegian man, Jon Fjalestad, in 1987, and moved to Norway.

Her family has decided to bury her in the town of Lunner, Norway, close to the four children who survived her. "She gave her life for Norway, so she should rest in Norwegian soil," Mr Sorensen added.

Breivik spent nine years plotting the atrocity, sending out a 1,518-page "manifesto", explaining the motives behind his actions and, allegedly, even set off a bomb in Oslo as a way of distracting police ahead of his rampage in Utoeya.

Geir Lippestad, defending, hinted at a possible insanity defence last week. "This whole case has indicated that he's insane," he said. However, Dr Rygnestad said such detailed planning and execution may not have been possible for someone under the influence of psychosis.

"It's not very likely he was psychotic," he said. "If you have voices in your head telling you to do this and that, it will disturb everything, and driving a car is very complex.

"How he prepared for the rampage - meticulously acquiring the materials and skills he needed to carry out his attack while maintaining silence to avoid detection - argues against psychosis."

In Norway, an insanity defence requires that a defendant be in a state of psychosis while committing the crime with which he or she is charged.

That means the defendant has lost contact with reality to the point that they are no longer in control of his own actions. Breivik will now be examined by two court-appointed psychiatrists.

Their findings will then have to be reviewed and approved by a forensic board, before the report goes to the judge hearing the case. The judge will then decide whether Breivik can be held criminally liable.