Hospital.Help

Karlsruhe – The Federal Constitutional Court in Karlsruhe will rule on a particularly difficult issue tomorrow. It’s about compulsory medical treatment of people who are being cared for.

The question is whether those affected absolutely have to be treated in hospital or whether this should also be possible in the facility where they live. Legal care is provided to people who cannot make decisions for themselves due to illness or disability (ref. 1 BvL 1/24).

These can be, for example, people with a serious mental illness, an intellectual disability or dementia. If they need urgent medical treatment but do not consent, they may be forcibly treated. However, there are high legal hurdles for this.

People may only be subjected to compulsory treatment if the treatment is absolutely necessary, otherwise there is a risk of serious damage to their health, and if the benefit outweighs the risk.

In addition, an attempt must be made beforehand to convince those affected. Only if they do not recognize the need or cannot act accordingly can compulsory treatment be given. The presumed will or, in healthier times, set out in a living will must also be taken into account.

The law stipulates that compulsory treatment may only take place in hospitals, where both medical care and follow-up treatment are guaranteed. This regulation is the only issue before the Constitutional Court.

The Federal Court of Justice (BGH) submitted the question to the constitutional judges. He has to decide on the case of a woman with paranoid schizophrenia who lives in an institution. Her supervisor requested that she be given the medication for the psychosis – which she did not want to take – there and not in the hospital because she would be retraumatized there.

In the past, she sometimes had to be restrained and given a spit guard in order to be taken to the clinic for compulsory treatment. However, the courts initially responsible did not agree to the guardian’s application. The woman turned to the BGH.

This considers it unconstitutional that compulsory treatment must take place in hospital without exception, even if this could harm people and they could also be treated in their facility. He suspended the proceedings in November 2023 and asked the Constitutional Court whether the regulation was compatible with the Basic Law.

This must now weigh up the protection of those affected against their civil liberties. It is about one of the “most fundamental rights-sensitive areas of adult protection,” as Court President Stephan Harbarth said at the hearing in July. How the judges decided will become clear tomorrow. © afp/aerzteblatt.de