Zusammenfassung
Die Indikation allein reicht zur Rechtfertigung des ärztlichen Eingriffes nicht. Hinzukommen
muss die Einwilligung des durch einen Arzt aufgeklärten Patienten. Sind anstelle des
Patienten andere Personen berechtigt, für ihn zu entscheiden, so sind diese aufzuklären.
Dabei ist der Patient über sämtliche für die Einwilligung wesentlichen Umstände rechtzeitig
und verständlich aufzuklären, ggf. unter Hinzuziehung eines Sprachmittlers bei fremdsprachigen
Patienten.
Abstract
An indication for a medical intervention alone is not sufficient to justify its implementation.
In addition, consent has to be obtained from the patient who has been given relevant
information by a doctor. If, instead of the patient, other persons are entitled to
decide for him (parents for children incapable of consent, authorised representatives,
carers), they must be informed. If the patient, who is aware of the significance of
his decision, refuses to consent to the measure as a whole or to parts of it, the
physician is bound by it – even if the patientʼs refusal is based on religious, ideological
or other reasons which are not comprehensible to the physician. In urgent cases, and
in the case of a patient unable to give consent, the doctor can initiate treatment
according to the principle of so-called presumed consent. The physician must inform
the patient about all circumstances essential for the consent in a timely and comprehensible
manner, i.e. also in the language of the patient in the case of patients who do not
understand German. The patient must be informed about alternatives if there are other
common treatment methods that are medically equally indicated, but which carry substantially
different burdens, risks or chances of recovery. From a medical and forensic point
of view, risk education is of the greatest importance, in particular information about
the typical risks specific to interventions which are unknown to the patient and which,
if they materialise, might have a lasting adverse effect on the patientʼs lifestyle.
The extent of risk disclosure is influenced by the urgency of the intervention; the
scope of risk disclosure is in inverse proportion to its urgency. An enlightened or
otherwise adequately informed patient (e.g. in the case of a series of dressing changes
under general anaesthesia) does not have to be enlightened every time, provided that
the risk spectrum for the patient has not changed. Consent and clarification are also
verbally effective, written form is strongly recommended for reasons of preserving
evidence. However, the patientʼs right to self-determination also means that the patient
can expressly dispense with more detailed information. Such a waiver should be carefully
documented.
Schlüsselwörter
informed Consent - Einwilligung - Selbstbestimmungsaufklärung - Risikoaufklärung -
Sicherungsaufklärung
Key words
informed consent - consent - self-determination - risk - safety
