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Critique of Patients Rights in Germany

6. August 2003: this Internet publication is a "Hearing": Please give comments to: walter.keim@gmail.com. Have I forgotten somebody on the list further down?

Patients rights are a reflection on human rights¹ and can be found all over Europe and the developed countries of the world. To use the right of self determination (Article 2 (2) Basic Law: Right to life and physical integrity ²) also towards doctors, the health system and to contribute to realize patients rights, the following rights would be beneficial:
1. Right to access all documentation, without having to prove a special interest.
2. Right to get information on rights and how to complain.
3. Right to complain to an independent body without costs.
4. Right to a fair answer in reasonable time.
5. Correction of mistakes in patient documentation.
The Charter of the Fundamental Rights of the European Union³ includes Freedom of Information in Article 42³. the right to get to know documentation in Article 41 (2)³, right to complain in Article 43³ (Ombudsman) and the right to a fair answer in reasonable time in Article 41 (1)³ . On the basis of the Fundamental Rights of the EU Active Citizenship Network⁴ has defined these rights for patients in the European Charter of Patients Rights⁵ . The EU has 1979 proclaimed Patients Rights for Hospital Patients⁶ and the WHO published 1994 general Patients Rights⁷. Article 10 of the Convention of Human Rights and Biomedicine⁸ secures the right to access to any documentation about own health. The realization of these rights by laws is shown for European countries: http://wkeim.bplaced.net/patients.htm¹ and Norway: http://wkeim.bplaced.net/gesetze.htm⁹.
Why not in Germany?

I criticize and accuse:

• A doctor from Gmünd because he refused to give access to patients documentation¹⁰ and he did not answer for one year¹¹.
• The doctors chamber Nordwürttemberg, because this refusal was tolerated¹² and the complaint¹³ was misunderstood and the complainant given the blame¹⁴. Here it was shown that doctors protect there own. Doctors chambers lack the independence to secure patients rights, i. e. those who decide on complaints could be fired if supporting patients too much. (An employee of the KV, who did not cover fraud payment¹⁵ was fired¹⁶). The lawyer answering the complaint can not instruct a doctor according to § 2 (4) of the doctors code¹⁷ . Therefore the patient lowest in hierarchy gets the blame.
• The federal chamber of doctors (Bundesärztekammer), because no information is given¹⁸ about the supervision through Landesärztekammer¹⁹ and control by the minister of social affairs.
• The chamber of doctors (Landesärztekammer) Baden-Württemberg, because it at last asked the doctor to give access²⁰, but did not contribute to process the complaint (send from the ministry of social affairs)²¹ . Because their is no access to the communication between doctor and doctors chamber, their is no chance to find out who made the mistake. But I was prepared for that and refused the doctor to give information without my consent. Therefore it seems clear that informal self determination was violated²². But because access is denied, this can not be proofed.
• The ministry of social affairs of Baden-Württemberg only has legal supervision²³, no supervision on facts. The complaint is misinterpreted²⁴ and legal supervision not taken seriously²⁵. The incomplete access to patient documentation is not dealt with, access to communication is denied. The supervision can not comment on what is actually done and in the legal questions self evident rights of the EU Charter of Fundamental rights (e. g. access) are violated.
• The ministry of interior of Baden-Württemberg writes not to be the right address²⁶ for The privacy complaint²⁷. A legal instruction²⁸ is not given, because only opinions are allowed²⁹. A question about legal advice³⁰ about the deficiency in the doctors code is not answered³¹.
• The authors of the Charter of Patients Rights 2002³² forgot the right to correct mistakes in patient documentation, which was mentions in Patients Rights in Germany" of 9./10. June 1999³³ .
• According to the doctors professional code of 10. April 2003 only access to objective parts of patient documentation, see §10 (2): "no access to ... parts, containing subjective impressions and observations of doctors." The parliament of Baden-Württemberg did not change the doctors code to reflect the newest judgment (1 BvR 1130/98⁹⁴) of the constitutional court that the a reason has to be given for the denial of access. therefore the doctors code only reflects court decisions 20 years old.
• Health insurance companies should help patients. But the AOK health insurance does not give access to documents and gives no information how to complain³⁴ . An example is the complaint of 2. April 2000³⁵ . Hear the traditional paternalistic culture of administration ³⁶ was followed, not the rights the Charter of Fundamental Rights of the EU³⁷ . In consequence the right to complain is forgotten³⁸, when patients rights are described.
• The parliament Landtag of Baden-Württemberg, because the answer³⁹ of the committee of petitions is only a copy of the letter of the ministry⁴⁰ . Therefore it is no surprise that the committee refuses access⁴¹. Deficiencies of access rights and the need to adapt laws to European standard is not seen.
• The parliament (Landtag) of Baden-Württemberg, because it was too avaricious ⁴² to give freedom of information: http://wkeim.bplaced.net/files/petition_bw_3.pdf (much administration, not inconsiderable costs, "erheblicher Verwaltungsaufwand, nicht unerhebliche Kosten"). Therefore the human right of freedom of information ⁴³ is not given to citizens.
• The parliament, government and administration denies Germans the right to get an answer from the administration.  EU Charter of Fundamental Rights ³⁷ gives a right of access to documents (Article 42) and the Right to good administration (Article 41), i. e. answer fairly within a reasonable time. (see also "The European Codex of Good Administration⁴⁴") German administration has no obligation to give reasons for its decisions and does not give these rights to its citizens. Suggestions to translate recommendations of the Council of Europe on freedom of information and patients rights have not been answered: http://wkeim.bplaced.net/020106coe.htm ⁴⁵ , http://wkeim.bplaced.net/filer/011223fischer.htm ⁴⁶ and http://wkeim.bplaced.net/files/020214bmi.htm⁴⁷. No reason is given.
• The German parliament and government because laws from the Third Reich ⁴⁸ are still in force. The allies declared Hitler's dictatorial government illegal, but forgot to abolish the laws Hitler made. Lawyers have a monopoly ⁵² about legal counselling according to the Law on legal advice ⁵¹ (Rechtsberatungsgesetz ⁵⁰ from 1935⁴⁹). In those days the law was given to exclude Jewish lawyers after they were expelled from the lawyers chamber and prevent that they give free advice. Even the press is obstructs from reporting on legal questions ⁵³ . This law is challenged with help of a constitutional complaint ⁵⁴(amendment ⁵⁵ of 5.May.2000) by a judge who was punished, because he gave free legal advice to friends. A Jew working for a voluntary organisation for integrating refugees was also punished, because of legal advice to Jewish immigrants. A complaint at the European Court of Human Rights was filed 13. November 2003. Consumers rights are violated.
• The parliaments on federal and local level because the privileges for doctors ⁵⁷ from Nazi times⁵⁶ (Seek after⁵⁸: "45% aller Ärzte waren NSDAP-Mitglieder", and "Hälfte der deutschen Ärzte ... Mitglieder der NSDAP"⁵⁹ : halfparten of doctors were Nazis) and lawyers bar (Percentage of NSDAP Members in legal system was 80%⁶⁰) is still kept. there is no rational reason why doctors and lawyers should have sovereignty functions (same legal rights as communities). A patient rights law and a lawyer client law should be given ⁶¹, to protect the rights of patients and lawyers clients, because both doctors chambers and bars do not give the rights of the Charter of the Fundamental Rights of the EU ³⁷ e. g. access see Article 41³⁷ (2) and the right to a fair answer within reasonable time see Article 41³⁷ (1).
• The constitutional court refused to process the complaint http://wkeim.bplaced.net/v-klage_en.htm ⁶² on freedom of information and patients rights ⁶³ without giving any reasons ⁶⁴ . The acknowledgement of human rights is only on paper. The acknowledgement of Article 1 (2) GG ² is not more then lip service (Lippenbekenntnis) ⁶⁵ . Germany was condemned in the case Vogt v. Deutschland ( - 7/1994/454/535 - EuGRZ 1995, 590 - ) to have violated Freedom of opinion by the European Court of Human Rights. But Germany does not respect this and tries to neglect this verdict. International law is not given precedence, as the constitution requires (Article 25 GG ²). The Fundamental Right of the of the EU ³⁷ Charter, to get an answer giving a reason (Article 41), is removed by the constitutional court even ⁶⁷ for petitions ⁶⁶. The European Court for Human Rights ruled that court decisions are to be fair⁶⁸ i. e. their has to be given a reason.
• The federal parliament because the petition on patients rights⁶⁹ was ceased⁷⁰, without answering the human rights questions⁷¹, the EU Charter and patients rights in the other European countries (apart from Norway).
• The federal ministry of health does not see the need for improvement⁷² to catch up with other European countries. The answer⁷³ shows that old rules from predemocratic inspired judgments are still in force⁷⁴.
• German patients finance the most expensive health system per person the EU (ca. 225 billion € a year), but when it comes to the quality of the services Germany is on place 13 of 15 in EU: http://www.vz-nrw.de/SES79823442/doc1293A⁷⁵ see also the experts report of German official panel of health experts 2000/2001: http://www.svr-gesundheit.de/gutacht/sogu00/kurzf00.pdf⁷⁶, see also World Health Report 2000⁷⁷: Place 25⁷⁸ among industrialized countries. A health system so bad as the German system is available in EU for ca. 45 billions € (EURO) less. The best health system in EU (France) is still ca. 23 billions € (EURO) (ca. 1 % GNP) cheaper. Where remains the money, which does not come to patients as service, who is benefiting the system? Why do patients not change this system? Structural changes are necessary according to Transparency International and fight of corruption.
• The German people and patients would be strong together, to achieve their rights but rests of the authoritarian era of the past are still accepted. The acknowledgement of human rights ⁹⁵ Article 1 (2) GG is so far false and only lip service. But that's democracy: Do voters get what they deserve, because they did not choose better? Why are there so many people who accept that human rights are missing? Why is there not more engagement for own (human-)rights?

Questions:

Will the prosecutor of the chamber of doctors be independent enough to support patients rights⁷⁹? (Even if the court of the doctors chamber collects fees for the decision not to deal with a complaint⁸⁰). Question regarding schedule of fees⁸¹ (pdf).

Will self help groups be backed up in the public and be heard by the parliament? E. g. the "Allgemeiner Patienten-Verband e.V.": http://www.patienten-verband.de/ ⁶¹, the Bundesarbeitsgemeinschaft der Notgemeinschaften Medizingeschädigter e.V.⁸²  (Petition PDF-Format.) and victims of mistakes of doctors: http://www.geburtsschaden.de/ ⁸³ und http://www.aerzte-pfusch.de/ ⁸⁴.

Will the WHO, promoting the "European partnership for patients rights and citizens’ empowerment ⁸⁵" , support patients rights? Unfortunately this programme seems to lack activity since 1999⁸⁶.

The Charter of Fundamental Rights of the EU gives Freedom of Information in Article 42, access to documents in Article 41 (2), the right to complain in Article 43 (Ombudsman) and the right to answers within reasonable time in Article 41 (1). The "European Codex of god Administration" defines latest two months to get an answer (Article 17). As EU-Citizen I would like to ask: How long will the EU Commission and the European Parliament (Courrier du Citoyen) look at that my human right of freedom of information and other fundamental rights of the EU Charter and the European Charter of Patients Rights⁹¹ are violated. In other countries in Europe this is respected. I become a second class citizen travelling to Germany.

I refer to the "European Parliament resolution on the situation as regards fundamental rights in the European Union (2000) (2000/2231(INI))" document A5-0223/2001. Point 3 "(n)otes that it is the particular responsibility of the European Parliament (by virtue of the role conferred on it under the new Article 7(1) of the Treaty of Nice) and of its appropriate committee to ensure (in cooperation with the national parliaments and the parliaments of the candidate countries) that both the EU institutions and the Member States uphold the rights set out in the various Chapters of the Charter" Will the petition http://wkeim.bplaced.net/petition_eu.htm be answered positive?

Will the European Convent solve these problems⁹³ and give the Fundamental Rights of the Charter of the EU also for EU member states? According to Com 2002/0247 the "Union must build up an EU-wide area of freedom, security and justice" with a "guarantee for the principles of democracy and respect for human rights". How long will EU tolerate member states not respecting human rights ⁹⁵?

Walter Keim

E-mail: walter.keim@gmail.com
Support freedom of information: http://wkeim.bplaced.net/foi.htm, http://wkeim.bplaced.net/petition_un.htm,
http://wkeim.bplaced.net/v-klage_en.htm
Support patients rights: http://wkeim.bplaced.net/patients.htm#e-mail

Ältere Entwürfe, Version: 0.0, Newest version.

Enclosure:

1. Patients Rights in Europe: http://wkeim.bplaced.net/patients.htm
2. Grundgesetz der Bundesrepublik Deutschland: http://www.verfassungsgericht.de/gg.htm
3. Charter der Grundrechte der Europäischen Union: http://www.sidiblume.de/info-rom/europa/2000c364_01.htm
4. Active Citizenship Network: http://www.activecitizenship.net/
5. European Charter of Patients Rights: http://wkeim.bplaced.net/files/european_charter.htm
6. EU 1979: Charta der Patientenrechte für Krankenhauspatienten: http://www.hope.be/07publi/publoth/Hospchart.htm
7. WHO hat 1994 allgemeine Patientenrechte proklamiert: http://www1.umn.edu/humanrts/instree/patientrights.html
8. Article 10 des Übereinkommens über Menschenrechte und Biomedizin: http://book.coe.fr/conv/de/ets/164-de.htm#A-10
9. Patientenrechte in Norwegen: http://wkeim.bplaced.net/gesetze.htm.
10. Verweigerung der Einsicht in Arztunterlagen: http://wkeim.bplaced.net/files/000606dg.htm
11. Ein Jahr lang keine Antwortet: http://wkeim.bplaced.net/files/000719ab.htm
12. Bezirksärztekammer Nordwürttemberg 23.10.2000: http://wkeim.bplaced.net/files/001023bzak.pdf
13. 19.7.2000: Klage an Bezirksärztekammer: http://wkeim.bplaced.net/files/000719ab.htm
14. 8.4.2001: An Bezirksärztekammer: http://wkeim.bplaced.net/files/010408bzak.htm
15. KV Abrechnungsbetrug: http://www.spiegel.de/spiegel/0,1518,228591,00.html
16. Der Spiegel 52/2002: Kartell der Abzocker: http://wkeim.bplaced.net/files/kartell_der_abzocker.pdf
17. Ärztlichen Berufsordnung § 2 (4): http://www.bnf.de/originalia/mbo.html#BI2
18. Bundesärztekammer 2.10.2000: http://wkeim.bplaced.net/001002bak.htm#bak
19. Verbandsinterne Aufsicht der Bezirksärztekammer: http://wkeim.bplaced.net/001002bak.htm#010624
20. Landesärztekammer 12.06.01: http://wkeim.bplaced.net/files/010612abw.pdf
21. Klage an Sozialministerium: http://wkeim.bplaced.net/010509sb.htm
22. Selbstbestimmungsrecht verletzt und geschummelt: http://wkeim.bplaced.net/files/000719dg.htm
23. An Sozialministerium: http://wkeim.bplaced.net/files/petition3_sbw.htm
24. Sozialministerium 26.10.01: http://wkeim.bplaced.net/011026sb.htm
25. Sozialministerium 16.10.01: http://wkeim.bplaced.net/files/011016sm.pdf
26. Innenministerium 16.08.00: http://wkeim.bplaced.net/files/000816im.pdf
27. An Innenministerium 19.07.00: http://wkeim.bplaced.net/000719ib.htm
28. An Innenministerium 04.10.00: http://wkeim.bplaced.net/001004ib.htm
29. An Innenministerium: http://wkeim.bplaced.net/files/petition3_ibw.htm
30. An Innenministerium 20.07.00: http://wkeim.bplaced.net/000720ib.htm
31. Innenministerium 15.05.01: http://wkeim.bplaced.net/010515ib.txt
32. http://www.bmj.de/ger/themen/medizin_und_recht/10000616/
33. Patientenrechte heute: http://www.degam.de/S5_gmk_p.html
34. Petition: http://wkeim.bplaced.net/petition2.htm#petition
35. AOK 2.4.2002: http://wkeim.bplaced.net/files/000402aok.pdf
36. Verfassungsbeschwerde: http://wkeim.bplaced.net/v-klage.htm#hintergrund
37. Charta der Grundrechts der EU: http://www.sidiblume.de/info-rom/europa/2000c364_01.htm#art41
38. http://www.patientenrechte.de/mvpatientenrechte.html
39. Antwort auf Petition: http://wkeim.bplaced.net/petition3.htm#antwort
40. Sozialministerium Baden-Württemberg: http://wkeim.bplaced.net/files/020607sbw.pdf
41. http://wkeim.bplaced.net/files/petition3_p2.pdf
42. Petition Informationsfreiheit: http://wkeim.bplaced.net/petition_bw.htm#antwort
43. http://www.heise.de/tp/deutsch/special/frei/12314/1.html
44. http://www.euro-ombudsman.eu.int/code/pdf/de/code_de.pdf
45. Europarat: http://wkeim.bplaced.net/020106coe.htm
46. An Bundesaussenminister: http://wkeim.bplaced.net/files/011223fischer.htm
47. An Bundesinnenministerium: http://wkeim.bplaced.net/files/020214bmi.htm
48. http://www.verdi.de/oetv_2/intranet/fachbereiche/06__bund_und_laender/justiz/dokumente/das_rechtsberatungsgesetz_
49. http://www.tacheles.wtal.de/aktuelles/hammel/rechtsberatungsgesetz2.asp
50. Law on Legal Advice 1935 (Rechtsberatungsgesetz): http://wkeim.bplaced.net/files/ge_legal_advice_law_overview.htm
51. http://www.tacheles.wtal.de/aktuelles/hammel/rechtsberatungsgesetz2.asp
52. Bundesgesundheitsministerium 20.08.00: http://wkeim.bplaced.net/files/000820bmg.pdf
53. Press is hindered by the Law on Legal Advice 1935 (Rechtsberatungsgesetz): http://www.gabnet.com/jus/rberg1.htm
54. Verfassungsbeschwerde Dr. Kramer: http://www.tacheles-sozialhilfe.de/harry/view.asp?ID=110
55. Verfassungsbeschwerde Zusatz: http://www.tacheles-sozialhilfe.de/harry/view.asp?ID=111
56. http://www.gscbs.de/forum/aktuell/verdi/verdi0402.htm
57. http://www.kvberlin.de/STFrameset165/index.html?/Homepage/publikation/archiv/kvbla0702/kvb0702u.html
58. http://www.theo-physik.uni-kiel.de:81/~starrost/akens/texte/demgesch/heesch.html
59. http://www.kvberlin.de/STFrameset165/index.html?/Homepage/publikation/pk2002/pk061102.html
60. Umgang der Justiz mit NS-Vergangenheit: http://wkeim.bplaced.net/files/Umgang_der_Justiz_mit_ihrer_NS-Vergangenheit.htm#80
61. Patientenvereinigung: http://www.patienten-verband.de/
62. Verfassungsbeschwerde Informationsfreiheit: http://wkeim.bplaced.net/v-klage.htm
63. Verfassungsbeschwerde: http://wkeim.bplaced.net/v-klage.htm#patienten
64. Bundesverfassungsgericht: http://wkeim.bplaced.net/files/020621bvg.pdf
65. Berufsverbote: http://www.berufsverbote.de/docs/hh-dammann.html
66. Bundesverfassungsgericht:http://wkeim.bplaced.net/files/030310bvg.htm
67. Bundesverfassungsgericht: http://dejure.org/gesetze/rechtsprechung/Hollerlanderschliessung.html
68. http://www.justizskandale.de/1/schoeler_bverfg.html
69. Petition Patientenrechte: http://wkeim.bplaced.net/petition4.htm
70. Landtag Baden-Württemberg: Antwort auf Petition: http://wkeim.bplaced.net/petition4.htm#antwort
71. Petition: http://wkeim.bplaced.net/petition4.htm#menschenrechte
72. Petition: http://wkeim.bplaced.net/petition4_bgm.htm
73. Bundesministerium der Gesundheit: http://wkeim.bplaced.net/files/030314bgm.pdf
74. Bundesministerium der Gesundheit: http://wkeim.bplaced.net/files/030428bgm.htm
75. http://www.vz-nrw.de/SES79823442/doc1293A
76. Sachverständigenrates 2000/2001: http://www.svr-gesundheit.de/gutacht/sogu00/kurzf00.pdf
77. World Health Report 2000: http://www.who.int/whr/2001/archives/2000/en/index.htm
78. WHO Health ranking: http://www.photius.com/rankings/healthranks.html
79. Kammeranwalt: http://wkeim.bplaced.net/020322ab.htm
80. Landtag Baden-Württemberg: Petition 13-1413: http://wkeim.bplaced.net/files/L-BW-Petition_13-1413.htm
81. Gebührenordnung: http://wkeim.bplaced.net/files/Gebuehrenordnung.htm
82. Notgemeinschaft Medizingeschädigter e.V: http://www.bag-notgemeinschaften.de/Petition/petition.html
83. http://www.geburtsschaden.de/
84. http://www.aerzte-pfusch.de/
85. Europäischer Partnerschaftsverbund für Patientenrechte und die Befähigung der Bürger zum selbstbestimmten Handeln: http://bmj.com/cgi/content/full/318/7193/1234/b
86. Patients Rights in Europe: http://wkeim.bplaced.net/patienten.htm#WHO_1997
87. http://wkeim.bplaced.net/020418eu.htm
88. http://wkeim.bplaced.net/330166.htm
89. Petition to EU Parliament: http://wkeim.bplaced.net/petition_eu.htm
90. Courrier du Citoyen 23. February 2002: http://wkeim.bplaced.net/020823eu.htm
91. European Charter of Patients Rights: http://www.activecitizenship.net/health/european_charter.pdf
92. Lage der Grundrechte in der Europäischen Union (2000) (2000/2231(INI)): A5-0223/2001
93. Petition 25. April 2002: http://wkeim.bplaced.net/020427eu.htm
94. Bundesverfassungsgericht (BVerfG) 1 BvR 1130/98 vom 16.9.1998: http://www.bverfg.de/entscheidungen/text/rk19980916_1bvr113098
95. Violations of Human Rights in Germany: http://wkeim.bplaced.net/files/de_human_rights.htm

Support the Rights of Patients by E-Mail to the Federal Government in Germany

Many countries in the EU have laws securing the Rights of Patients. Germany is one of the countries in the EU without such a law. In order to keep up with the international development a law on patients' rights should also be adopted in Germany.

Support a German Patients' Rights Law, by the following E-Mail to the German Government (click here):
I support the call to the German Government for securing the rights of patients by law.
I suggest to implement the European Charter of Patients Rights http://wkeim.bplaced.net/files/european_charter.htm and the "Recommendation Rec (2000) 5 of the Council of Europe on the development of structures for citizen and patient participation in the decision-making process affecting health care": http://www.social.coe.int/en/qoflife/recomm/R(00)5.htm .
(You may change the text according to your needs).

Support the Rights of Patients by E-Mail to the European Commission with a copy to the European Parliament.

Many countries in the EU have laws or charters securing the Rights of Patients. But minimum standards are lacking.  In order to give all citizens in Europe a minimum of patients rights and to keep up with the international development patients rights should be strengthened in EU member states.


Support Patients rights, by the following E-Mail to the European Commission (click here):
I support the call to the European Commission for securing the rights of patients.
As a guideline I suggest to use European Charter of Patients Rights http://wkeim.bplaced.net/files/european_charter.htm and the "Recommendation Rec (2000) 5 of the Council of Europe on the development of structures for citizen and patient participation in the decision-making process affecting health care": http://www.social.coe.int/en/qoflife/recomm/R(00)5.htm .
(You may change the text according to your needs).

Visitor No. since 11. November 2003

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