Laum H D
Zentralbl Chir. 2000;125(11):920-5. doi: 10.1055/s-2000-10059.
Some experts postulate a doctor's "therapeutic privilege" on limited medical information, if complete information would overstrain the patient psychologically or if absolutely necessary therapy probably would be refused for incomprehensible reasons. The German Federal Court, however, does not conform with this opinion. According to its jurisdiction the doctor is obliged to considerate information, but only allowed to neglect full information, if the declaration of the diagnosis would cause a serious and irreparable damage to the patient's health. Causing concern, depression or deterioration of the patient's general condition, however, is regarded as inevitable detriment. If the patient does not agree to a radiotherapy, the doctor must not shy away from disclosing the cancer diagnosis. Reducing medical information is therefore only allowed in exceptional cases, because otherwise the patient's right of self-determination would be undermined. Until now the Federal Court did not accept reduction of medical information for therapeutic reasons in one single decision. Though the doctor must not disclose cancer diagnosis if the patient doesn't ask about it, he will have to inform him about the risks of the indicated therapy. The patient, however, has the right to waive information. His renunciation, however, has to be unambiguous and has to be documented contemporarily.
一些专家假定，如果完整的医疗信息会在心理上使患者不堪重负，或者如果由于难以理解的原因患者很可能会拒绝绝对必要的治疗，医生对有限的医疗信息享有“治疗特权”。然而，德国联邦法院并不认同这一观点。根据其管辖权，医生有义务提供周全的信息，但只有在宣布诊断会对患者健康造成严重且无法弥补的损害时，才允许忽略完整信息。然而，引起患者担忧、抑郁或总体状况恶化，则被视为不可避免的损害。如果患者不同意进行放射治疗，医生绝不能回避透露癌症诊断。因此，只有在特殊情况下才允许减少医疗信息，否则患者的自决权将受到损害。到目前为止，联邦法院在任何一项裁决中都未接受出于治疗原因减少医疗信息的做法。尽管如果患者不询问癌症诊断情况，医生不必透露，但他必须告知患者所建议治疗的风险。然而，患者有权放弃信息。不过，他的放弃必须明确无误，并且必须同时记录在案。
