Einwilligungsfähigkeit bei älteren, vor allem dementen und verwirrten (deliranten) Patienten

Abstract

In the treatment of elderly patients the question often arises whether they are able to give an informed consent to medical operations. According to German jurisdiction the patient must be able to comprehend the kind, the aim and the consequences of the projected surgical operation as well as to declare his will. If this is not the case, he cannot give an informed consent, being "under disability" and in Germany a guardian has to be installed by the court. E.g., moderately demented or delirious patients are unable to give an informed consent to medical operations. A discussion on this topic is under way, as to whether a patient has the right to give an informed consent in advance in case of becoming unable to declare his will (in dementia etc.).

Esophageal hernia in dementia: surgeon’s role for mixed-type esophageal hernia in an elderly woman with dementia

“…and operations on demented or delirious patients, unable to give informed consent, is undecided in juridical terms in certain countries. 13 But the present patient could avoid use of any restraints by constructing gastrostomy to aid the oral alimentation, which is the appropriate procedure. After confirming that oral feeding is sufficient, removal of the gastrostomy tube is in order.…”

Stellvertreterentscheidungen in Gesundheitsfragen und Vorausverfügungen von Patienten

“…mehr oder weniger eingeschränkt) einwilligungsfähig im juristischen Sinne sein kann [22,25,29]. mehr oder weniger eingeschränkt) einwilligungsfähig im juristischen Sinne sein kann [22,25,29].…”

“…Folglich gehört zu jedem ärztlichen Aufklärungsgespräch, dass man zunächst sowie nicht selten durchaus kritisch (s. oben) die tatsächliche Einwilligungsfähigkeit des Patienten zu überprüfen hat [25,29].…”