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18th Symposium of Central and East European Chambers of Physicians (ZEVA) Country Report: Germany. 30 September – 1 October 2011 in Cracow. Dr. Klaus-Dieter Wurche. 114th German Medical Assembly Elections Ethical issues Healthcare policy
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30 September – 1 October 2011 in Cracow
Dr. Klaus-Dieter Wurche
German Medical Association:
President - Dr. Frank Ulrich Montgomery (Hamburg)
Vice-President - Dr. Martina Wenker (Lower-Saxony)
Vice-President - Dr. Max Kaplan (Bavaria)
Secretary general of German Medical Assembly and German Medical Association retired.114th German Medical AssemblyElections
July 2010: Federal Court ruling highlighted lack of explicit regulation within the Embryo Protection Act regarding PGD
Calls for legislators to clarify legal status of PGD in Germany = lengthy debate in politics and society
Position of the medical profession formulated at 114th GMA:
“Ethical considerations favour permitting PGD within limited
boundaries and subject to certain conditions”
July 2011: New law passed permitting PGD under certain circumstances. Each case must be individually assessed by an ethics committee114th German Medical AssemblyEthical issues
June 2010: Ruling by the Federal Court stating that physicians, carers or relatives who carry out the express wishes of a patient to withhold life-extending treatment cannot be prosecuted.
February 2011: German Medical Association published revised guiding principles on physician-assisted suicide:
”It is not the task of a physician to assist a person in taking his/her own life.”
Delegates of the 114th German Medical Assembly demanded stronger wording to emphasise that physician-assisted suicide is also contrary to the ethos of the medical profession
Professional Code under revision to incorporate demand für stronger wording114th German Medical AssemblyEthical issues
Action imperative however should be based on incentives rather than punitive measures
Cross-sector dimension essential to requirements planning rather than exclusively sector-specific
Consequence: Chambers of Physicians must be included into requirements planningHealthcare policyLegislation to improve the structure of SHI healthcare provisions in ambulatory care
Balances the interests of patients and physicians:
protects patients from excessive premium payments
ensures that physicians and hospitals can cover their expensesHealthcare policyReform of physicians‘ remuneration
Last complete revision 1983 = GOÄ hasn’t kept pace with price rises, medical progress not taken into consideration
Healthcare increasingly market-orientated = revised GOÄ essential to avoid price dumping at the expense of quality
The GMA has produced a comprehensive and detailed suggestion for a new GOÄ and its continuous development based on an expert analysis.
Demand: No exemption clause, no selective agreements between individual physicians and private health insurance companies.Healthcare policyReform of physicians‘ remuneration
Federal Government plans to introduce new patients’ rights legislation to strengthen the position of patients with respect to service providers and health insurance funds
Existing laws to be consolidated into one legislative text
Especially with relation to patient safety and processes for obtaining compensation in the event of medical malpracticeHealthcare policyPatients‘ rights
Patients’ rights in Germany are already sufficiently protected under law, the problem is rather a lack of access to objective information on them
The professional code of the medical profession binds physicians to observe patients’ rights in a spirit of partnership
Further legal regulation would be likely to create additional bureaucracy to the detriment of physiciansHealthcare policyPatients‘ rights