PubMed · 4118925
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C Barth. 1972. [The Batthyaneum].. https://pubmed.ncbi.nlm.nih.gov/4118925/
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Until the early seventies escalating costs in the health care sector were accepted as being a necessary consequence of social progress. However, this view has since begun to shift. Due to the recession in the mid-seventies, mounting health expenditures now loomed as a threat to the economy. Rather than social progress, the issue now was measures to curb the rising costs and increase-insurance revenues. Rising health care contributions initiated by the government coalition of Social Democrats and the Liberal Party marked this change of perspective in health policy that led to restraints in the principle of solidarity within the statutory health insurance system and, as a result, to a renewed privatisation of health expenditures. Since then patients who had health insurance were obliged to pay a larger share of their health expenses.
Within the framework of the planned law concerning the removal and transfer of organs (transplantation law) in the Federal Republic of Germany, and taking as a basis the draft of a prototype law by the federal states dated February 1st 1994 and the draft bill of the states of Bremen and Hessen dated June 30th 1994, the speech addresses itself primarily to the question of whether, when no consent of the decreased can be identified, and when the next-of-kin have been informed by the doctor in attendance and given an appropriate time-limit, the next-of-kin in order of succession or any close relative can object to organ removal for the purpose of transplant surgery. Because of the highly personal nature of the postmortal personal rights transferred to the next-of-kin as well as their custodial rights, and with regard to the particularly sensitive nature of this decision, it is suggested that the next-of-kin be informed not only of their right of refusal but also-in view of their responsibility toward other relatives-be instructed on the meaning, substance and legal consequences of such a refusal. It is furthermore suggested that sufficient organs could be obtained by organisational measures such as requests to driving licence applicants, which would lead to a higher preparedness to donate organs, while, at the same time, sparing the next-of-kin unnecessary emotional pain. From a medical point of view, it should be recognised that the complete and irreversible loss of all brain functions, in spite of artificially maintained heart and circulatory functions, is a sure sign of death. In closing, it is pointed out that a change to the currently valid [symbol: see text] 168 StGB would mean that a violation of the right of refusal could lead to criminal prosecution.
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