Höfling Wolfram
Institut für Staatsrecht, Köln.
Z Evid Fortbild Qual Gesundhwes. 2009;103(5):286-92. doi: 10.1016/j.zefq.2009.05.002.
"Individual responsibility" and the abidance by any "health-related obligations" are key words of the present political and legal German healthcare debate. In the process of adjusting the German welfare state by focussing the ideal allocation of common health resources patients who do not meet their "health-related obligations" are thus expected to accept cutbacks in medical care services. However, from the perspective of constitutional law there is no "health-related obligation" deriving from the German constitution - the right to self-determination guaranteed in Art. 2 Sect. 2 Sent. 1 of the German constitution has not been amended to impose a corresponding duty. Hence, health-related obligations may only refer to indirect ways of exercising individual responsibility, no more and no less. The present article highlights the few possibilities which the German constitution provides for the implementation of "health-related obligations" and reminds us of the conceptual aspects which have to be considered by the legislator.
“个人责任”以及遵守任何“与健康相关的义务”是当前德国医疗保健领域政治和法律辩论的关键词。在通过关注公共健康资源的理想分配来调整德国福利国家的过程中，那些未履行“与健康相关义务”的患者因此被期望接受医疗服务的削减。然而，从宪法角度来看，德国宪法并未衍生出“与健康相关的义务”——德国宪法第2条第2款第1句所保障的自决权并未被修改以施加相应的义务。因此，与健康相关的义务可能仅指履行个人责任的间接方式，不多也不少。本文强调了德国宪法为实施“与健康相关的义务”所提供的几种可能性，并提醒立法者必须考虑的概念性方面。
