What kind of support does a cancer patient need?

Patient rights & social benefits

When to treat, how to treat? Your right to self-determination

Frequently, patients and their relatives are not aware of the possibilities of having a say and self-determination in cancer therapy. In fact, however, they have extensive opportunities to have a say in the treatment.

In the meantime, it has also been anchored in the German Civil Code (§§ 630a ff.) That every patient must consent to medical treatments so that they can be carried out in a legally permissible manner. The essential rights of patients and the obligations of the treating doctors and clinics are summarized below.

The patient's consent is essential

The patient has the unrestricted right to self-determination. Therefore his free consent is an indispensable prerequisite for any medical intervention. Before carrying out a medical measure, especially in the case of an intervention in the body or health, the treating person must obtain the patient's consent. If there is no effective consent and this could not be waived, the medical treatment is an unlawful bodily harm.

Consent may only be waived in very special cases. This only applies if it cannot be obtained in time due to a measure that cannot be postponed and the measure corresponds to the presumed will of the patient. Clues as to whether it corresponds to the presumed will of the patient can be given by the patient's previous statements about certain treatments. Therefore, family members and confidants can make an important contribution to discovering the patient's will.

In order for his consent to be effective, the patient must first be properly informed by the doctor.

Consent requires clarification - without clarification, no consent!

The attending physician is obliged to inform the patient about all circumstances relevant to the patient's decision so that the patient can give informed consent. The purpose of the information is to enable the patient to make a self-determined decision as to whether he or she would like to have the proposed procedure carried out or whether he or she would like a different therapy, or whether he or she may even forego treatment.

What needs to be clarified depends on the specific circumstances of the individual case. In principle, the doctor must inform the patient about all factors that enable the patient to weigh up the “pros and cons” of the treatment. This includes, among other things, circumstances such as the necessity and chances of success of the treatment, its type and precise implementation, and its risks. The doctor must also advise the patient about available alternative treatment options. The information provided must be understandable for the patient. In order to preserve their self-determination, patients can and should ask their doctor for additional information if anything is unclear or unanswered.

If the patient has consented to the treatment being carried out, the treating person must provide information on all aspects that are essential for the treatment and all circumstances to be observed during the treatment in order to ensure the success of the treatment (including information about the probable health development during the therapy and the or measures to be taken after therapy).

The clarification may only be omitted in narrow exceptional cases. The doctor may dispense with informing the patient if, in exceptional circumstances, this is unnecessary. Such special circumstances exist, for example, if the measure cannot be postponed or the patient has expressly waived the need to be informed.

Living will ensures compliance with the patient's will

If the patient is unable to consent, an advance directive can help. This is binding for the practitioner. In a living will, you can - in the event that one day you can no longer articulate your will - stipulate bindingly which medical measures you want and which you do not. You can also specify who should ensure that your wishes are implemented in medical matters.

The requirements for living wills are now regulated in the German Civil Code (Section 1901a). With an advance directive, you can therefore take precautions so that your will is observed in the event of an emergency.

The right to a second professional opinion

A second medical opinion is the second evaluation of a medical diagnosis or a therapy proposal by an independent doctor who is not involved in the treatment of the patient. A second opinion can help you to overcome uncertainties and to get a better overview of therapy alternatives. For example, it can be very important for assessing the risks and opportunities of a surgical procedure.

Medical questions such as the advantages and disadvantages of different treatment methods are not always easy to assess. Therefore, getting a second opinion can also help you make a decision between different treatment options.

Under certain circumstances, patients have the right to obtain an independent second medical opinion. The requirements for this second opinion are regulated in more detail for those with statutory health insurance in Section 27b SGB V and in a guideline on the second opinion procedure. Generally speaking, there is an entitlement to certain “planned interventions”. In addition, health insurance companies can provide additional benefits in their statutes for obtaining an independent second medical opinion.

You should therefore clarify in advance whether your health insurance company will cover the costs for a second opinion and which conditions apply to it. This does not affect your patient's right to obtain a second medical assessment and to bear the costs yourself.

Participation in clinical trials - opportunity or risk?

In clinical studies, drugs and treatment methods are tested on a large number of patients in selected facilities. The course of treatment follows a previously defined and approved test plan. The possibility of participation is linked to certain inclusion and exclusion criteria that the responsible investigator knows and the existence of which he can check on you.

Participation in a clinical study always requires the prior consent of the patient. The consent of the patient is also essential here.

Clinical studies are officially examined and monitored before they begin. An ethics committee also checks whether the provisions on patient protection are being adhered to.

Participation in a study offers patients the chance to receive a new therapy, for example if no established therapy option is effective. However, the new therapeutic approaches may not yet have been well researched. There is therefore a risk that the study therapy will not work for you after all, or that it will lead to side effects or interactions.

Whether it makes sense for a patient to participate in a study must be decided individually in each case. A detailed consultation and careful medical consideration with the attending physician are therefore essential.

Further information for patients

Further information on your rights as a patient can be found in the Guide to Patient Rights of the Federal Ministry of Health.

Print chapter