Ulrike Dengel from Ingolstadt is open about this. She received medical treatment against her will. That was about two years ago when she had a manic phase. At that time, a judge ordered her to be admitted to a clinic to protect her. The doctors even fixed her up. Although she still suffers from it and has nightmares, she believes that the doctors did the right thing back then: “I am firmly convinced that this had to be done.”
The obstacles to compulsory treatment are high
Mandatory treatment is ethically sensitive and the hurdles are high. A judge must order it and it can only be carried out in a hospital. It can only be used by people who are unable to make decisions for themselves due to illness or disability. At the same time, there must be a serious threat to their health, says Professor Thomas Pöllmächer.
The director of the Mental Health Center at the Ingolstadt Clinic and board member of the German Society for Psychiatry and Psychotherapy (DGPPN) gives further examples of how treatment may be necessary against the patient’s will: “Imagine a patient who is far from… The secret service seems to be following him and is so excited and nervous that he is endangering traffic. Or a pregnant patient who, because of her illness, cannot understand that her child cannot be born naturally and that a caesarean section is necessary.
Can outpatient treatment be better for the patient in individual cases?
These treatments can only be carried out in hospital. But there are also cases where different regulations could be less stressful for patients: for example, if dementia patients have to go to hospital specifically to take medication. The Federal Constitutional Court is now examining whether it is permissible to avoid hospital treatment.
This review came about because a legal guardian wanted to apply for an exemption for a woman. She had to be taken to a clinic regularly to take medication, although this was also possible at her care centre. The carer argued that having the patient admitted to a clinic puts additional pressure on her.
Federal Court of Justice issues ruling on compulsory treatment of constitutional judge
The judges of the Federal Court of Justice (BGH) initially dealt with the case. They stated that the current regulations violate the Basic Law if they are better for the patient in individual cases. They therefore referred the case to the constitutional judges. The case is now before the Federal Constitutional Court.
Ingolstadt professor Thomas Pöllmächer is one of the experts advising the judges. He is in favour of a case-by-case assessment: “How and by what means should depend less on the diagnosis, but should be examined and considered in each individual case. remedy that is available.”
It remains to be seen whether compulsory medication can also take place outside of clinics. The verdict is not expected for a few months. And there are also critics who are against opening up the regulation. They fear that the number of coercive measures could increase with exceptions.