title: [What is a "Considerable Damage to One's Health" in the Sense of German Guardianship Law?]
abstract: The term of a "considerable damage to one's health" is central in German guardianship law with respect to judge's decisions on involuntary commitment and coercive treatment. A legal definition has not been provided, and up to now no explanations from the part of medicine have been available what a "considerable damage to one's health" is in the case of mental illness and how it can be determined. A consensus paper of the German Association of Psychiatry and Psychotherapy (DGPPN) explains four possible scenarios of manifestation of such kind of damage, corresponding to somatic illnesses: evidence of structural brain lesions (rare), subjective suffering (sufficient, but not necessary), impairment of functioning in important areas of life, and severe impairment of social participation (e. g. by dangerous behaviour against others). This view corresponds with the WHO's bio-psycho-social concept of health.
authors.affiliation: Zentrum für Psychiatrie Südwürttemberg, Universität Ulm.
authors.forename: Tilman
authors.initials: T
authors.lastname: Steinert
authors.affiliation: Charité - Universitätsmedizin Berlin.
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.affiliation: Asklepios Fachklinikum Brandenburg.
authors.forename: Felix
authors.initials: F
authors.lastname: Hohl-Radke
authors.affiliation: Asklepios Klinik Göttingen, Universität Göttingen.
authors.forename: Manfred
authors.initials: M
authors.lastname: Koller
authors.affiliation: Asklepios Klinik Göttingen, Universität Göttingen.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Müller
authors.affiliation: Charité - Universitätsmedizin Berlin.
authors.forename: Sabine
authors.initials: S
authors.lastname: Müller
authors.affiliation: Kreiskrankenhaus Heidenheim.
authors.forename: Martin
authors.initials: M
authors.lastname: Zinkler
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003617:Dangerous Behavior; D004185:Disability Evaluation; D005858:Germany; D006801:Humans; D007872:Legal Guardians / Q000331:legislation & jurisprudence*; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D026684:Personal Autonomy