Neitzke Gerald
Anasthesiol Intensivmed Notfallmed Schmerzther. 2019 Jul;54(7-08):485-494. doi: 10.1055/a-0821-6759. Epub 2019 Jul 25.
Patients' rights need to be protected, particularly if the patient is unconscious or otherwise unable to consent. According to German law, a legal proxy is mandatory. Spouses and adult children do not automatically function as legal proxies. There are two alternative ways to become a legal proxy: a patient representative (Bevollmächtigter) is authorized by a written power of attorney (Vorsorgevollmacht), signed by the patient. If there is no power of attorney, a legal guardian (Betreuer) has to be appointed by a guardianship court. Both representatives and guardians are obliged to support the patient and are only allowed to make medical decisions, if the patient is currently unable to give his/her consent. The legal proxy is obligated to take into account advance directives, other patient preferences and presumed wishes. Recommendations and examples are given on how to apply these documents in medical practice and how to deal with legal representatives and guardians.
患者的权利需要得到保护，尤其是当患者失去意识或无法给出同意时。根据德国法律，必须指定法定代理人。配偶和成年子女并不会自动成为法定代理人。有两种成为法定代理人的替代方式：患者代表（Bevollmächtigter）由患者签署的书面授权书（Vorsorgevollmacht）授权。如果没有授权书，则必须由监护法院指定法定监护人（Betreuer）。代表和监护人都有义务支持患者，并且只有在患者目前无法给出同意的情况下，才允许做出医疗决定。法定代理人有义务考虑预先指示、患者的其他偏好和推定意愿。文中给出了关于如何在医疗实践中应用这些文件以及如何与法定代表人和监护人打交道的建议和示例。
