Steinert Tilman, Heinz Andreas, Hohl-Radke Felix, Koller Manfred, Müller Jürgen, Müller Sabine, Zinkler Martin
Zentrum für Psychiatrie Südwürttemberg, Universität Ulm.
Charité - Universitätsmedizin Berlin.
Psychiatr Prax. 2016 Oct;43(7):395-399. doi: 10.1055/s-0042-116649. Epub 2016 Oct 12.
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.
在德国监护法中，就法官关于非自愿住院和强制治疗的裁决而言，“对健康造成相当大损害”这一术语至关重要。法律并未给出其定义，截至目前，医学方面也未就精神疾病情况下的“对健康造成相当大损害”是什么以及如何确定给出解释。德国精神病学和心理治疗协会（DGPPN）的一份共识文件解释了这种损害表现的四种可能情形，这与躯体疾病相对应：脑结构病变的证据（罕见）、主观痛苦（充分但非必要）、生活重要领域功能受损以及社会参与严重受损（例如因对他人的危险行为）。这一观点与世界卫生组织的生物 - 心理 - 社会健康概念相符。
