[Legal problems in an elective cesarean section].
The requirements for a legal assessment of the Caesarean section on request can be deduced from the general criteria for the legitimacy of medical treatment: indication of treatment, adequacy of treatment (= quality) and informed consent. The problem of indication is of particular relevance under the aspect of criminal law. Even if one takes the view that a Caesarean section on request is an operation without indication this does not automatically amount to unconscionability as defined by sect. 226 a StGB (Criminal Code) since such an operation may be justified by the consent of the woman. This leads to the problem of comprehensive information on the risks of such an operation. Moreover, it appears to be questionable to reject the indication of an Caesarean section on request. The information requirements with reference to liability law can only be formulated with the background of the general information requirements for methods of delivery. The general principle that the greater the risk of operation and the more difficult the decision to be taken are, the more intensive should be the information provided, results in comprehensive duties of information in the case of the Caesarean section on request. At present, court rulings establish natural birth to be the first choice of treatment. However, if the risk/benefit assessment should lead to new results due to new medical findings in the future, this will require some discourse within the profession and possibly a new establishment of the medical standard. With regard to the professional aspect, the doctor in charge is entitled to refuse a Caesarean section on request.
Institut für Gesundheits- und Medizinrecht der Universität Bremen. kabecker@uni-bremen.de
K
K
Becker-Schwarze
D002585:Cesarean Section / Q000592:standards*; D017558:Elective Surgical Procedures / Q000592:standards; D005260:Female; D005858:Germany; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D007883:Legislation, Medical; D009774:Obstetrics / Q000331:legislation & jurisprudence* / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards; D011247:Pregnancy; D016079:Refusal to Treat / Q000331:legislation & jurisprudence