[Legally effective consent with minors and incompetent patients].
Legal consent to medical treatment requires comprehensive clarification and the patient's capability to consent. Minors under 14 years are usually not capable of consent -- the right to decide rests with the parents. With persons over 14 years the doctor must test for capability to consent. With adults incapable of consent the court-appointed guardian decides. In acute cases the doctor may act first and obtain permission afterwards. Contractual capability is decisive for a treatment contract to be effective and the doctor's claim for remuneration. Minors up to 7 years are absolutely contractually incapable. Since minors under 18 years are only limitedly contractually capable, the approval of the statutory guardian suffices. With contractually incapable adults the court-appointed guardian or in serious cases the Guardianship Court decides. The legal position is explained, using three sample cases.
Krukemeyer
M G
MG
Abt Chirurgische Forschung, Klinik und Poliklinik für Allgemeine Chirurgie, Universitätsklinikum Münster, Münster, Germany. dr.loitsch@web.de
Pflugmacher
I
I
Spiegel
H U
HU
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000601:surgery; D002648:Child; D003219:Confidentiality / Q000331:legislation & jurisprudence; D003284:Contract Services / Q000331:legislation & jurisprudence; D003560:Cysts / Q000601:surgery; D004750:Enteral Nutrition; D005260:Female; D005858:Germany; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence; D052177:Kidney Diseases, Cystic / Q000601:surgery; D007872:Legal Guardians / Q000331:legislation & jurisprudence; D008107:Liver Diseases / Q000601:surgery; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D033242:Minors / Q000331:legislation & jurisprudence*; D010353:Patient Education as Topic; D019724:Presumed Consent / Q000331:legislation & jurisprudence; D013244:Sterilization, Involuntary / Q000331:legislation & jurisprudence