Medical and Health Law

This chapter explains what German medical and health law actually gives you as a patient, what it does not give you, and how to tell the difference between a situation you can resolve yourself for nothing and a situation that needs a lawyer. It is written for people who live in Germany without German as a first language, because that fact changes several of the answers. It is not medical advice and it is not legal advice. Nothing here is a substitute for a doctor or for a Rechtsanwalt looking at your specific file, and the chapter is deliberately structured to tell you when you need one of those.

Most guides to this subject describe medical law as an abstract balance between medicine, ethics and the state. That is true and it is useless. What you need instead is concrete: the treatment contract you entered without signing anything, the records you can demand, the handful of situations where the burden of proof flips onto the doctor, the free routes that exist before you spend a euro on legal help, the clock that runs while you think about it, and the two documents that decide who speaks for you if you cannot speak for yourself. This chapter covers those in that order.

Where medical and health law starts: the contract you signed without signing anything

When you let someone treat you medically in Germany, you enter a Behandlungsvertrag, a treatment contract, under §630a of the Bürgerliches Gesetzbuch (BGB, the German Civil Code). It needs no signature, no form and no discussion. The Patientenbeauftragter der Bundesregierung, the federal government’s patient representative, puts it plainly: the contract comes into being as soon as you have yourself treated. It does not only apply to doctors. It applies whenever you are medically treated, so it covers your Physiotherapie and Ergotherapie appointments too.

Under §630a(1) the person who promises the treatment, called the Behandelnder in the statute, owes you the promised treatment, and you owe the agreed payment, unless a third party is obliged to pay. That last clause is why you rarely see a bill: your Krankenkasse, your health insurer, is the third party. The contract still exists and it is still yours. Whether you are in the gesetzliche Krankenversicherung (GKV, statutory health insurance) or the private Krankenversicherung (PKV, private health insurance) changes who pays and it changes one of the free routes described later in this chapter, but it does not change the contract. Our chapter on insurance essentials in Germany covers that split.

The most important thing this contract does is set the standard you are owed. Under §630a(2) treatment must follow the generally recognised professional standards existing at the time of treatment, the allgemein anerkannte fachliche Standards. Read that carefully, because it is a standard of process and not of outcome. §630b makes the ordinary German rules on a Dienstvertrag, a contract for services, apply to the treatment relationship. A Dienstvertrag owes effort, not success. You have a right to be treated to the standard. You have no right to be cured, and no right to a good result. The Patientenbeauftragter says the same thing in almost the same words: a right to treatment success or even to a cure cannot be derived from the contract. Every serious conversation about a suspected error starts from this sentence, and a great deal of anger and wasted money comes from not knowing it.

Aufklärung, and the language problem the law does not solve for you

Before a medical measure, the doctor must obtain your Einwilligung, your consent, under §630d BGB. That consent is only effective if you were properly aufgeklärt beforehand. Aufklärung is the German term for the explanation that must precede consent, and §630e sets out what it has to contain and how it has to be delivered. It must cover everything material to your decision: the nature, extent and conduct of the measure, its expected consequences and risks, its necessity, urgency, suitability and prospects of success. Where several methods are equally indicated and equally customary but lead to materially different burdens, risks or chances of recovery, the alternatives must be put to you as well.

The delivery rules in §630e(2) are the ones people do not know. The Aufklärung must be oral. It must come from the person treating you or from someone with the training necessary to carry out the measure. Written material can support the conversation but can never replace it. It must happen early enough that you can make a considered decision, which means a form pushed at you on a trolley outside the operating theatre is not a lawful Aufklärung. It must be comprehensible to you. And you must be handed copies of any document you signed in connection with the Aufklärung or the consent. If you signed something and left without a copy, ask for it; you are entitled to it by statute. Separately, §630d(3) lets you revoke your consent at any time, without any form and without giving reasons.

Now the part that matters most for foreigners, and the part where you must be careful about what the law actually says. The statute requires the Aufklärung to be “für den Patienten verständlich”, comprehensible for the patient. It does not use the word interpreter and it does not say who pays for one. What it means in practice is that an explanation you did not understand is not an Aufklärung, and consent given on the back of it is not effective consent. So where you do not command enough German, the treating side has to bridge that gap somehow, whether by using a colleague who speaks your language, by involving a person you bring with you, or by arranging an interpreter. Who bears the cost is a separate question and is genuinely contested; do not assume it lands on the hospital. Our chapter on the German healthcare system sets out the finding that matters here, which is that your Krankenkasse does not have to pay for an interpreter, with §17(2) of the Sozialgesetzbuch I (SGB I) as the one clear exception, covering Gebärdensprache, German sign language, at the social insurance body’s cost. Practically: if you did not understand, say so at the time, say so again, and do not sign. That sentence is worth more to you than any later claim.

Your records, and the first copy that is now free

Under §630f BGB your treating side must keep a Behandlungsakte, a treatment file, in immediate temporal connection with the treatment. It may be on paper or electronic. Corrections are only permitted if the original content stays visible alongside the change and the date of the change is recorded, and this must be ensured for electronic files too. The file must contain everything professionally material: the Anamnese, your medical history, the diagnoses, the examinations and their results, the findings, the therapies and their effects, the interventions and their effects, and, importantly for the previous section, the consents and the Aufklärungen. Arztbriefe, the letters doctors write to each other about you, must be filed in it. The file must be kept for ten years after the treatment ends unless another rule sets a longer period.

§630g is the one to memorise. On request, you must be granted access to the complete file concerning you, unverzüglich, meaning without culpable delay. You may demand copies, including electronic copies. And the first copy is free of charge. That last point corrects almost every older guide, including the previous version of this one: the statute now says “Die erste Abschrift wird unentgeltlich zur Verfügung gestellt”, implementing a 2023 ruling of the European Court of Justice, which the Patientenbeauftragter confirms in the same terms. Only further copies may be charged for. Access may only be refused so far as substantial therapeutic grounds or substantial rights of third parties stand against it, and any refusal must be reasoned. If someone refuses and gives you no reason, that is not a lawful refusal.

Two footnotes that catch people out. First, if the patient has died, the rights pass to the heirs so far as they are pursuing financial interests, and to the next of kin so far as they are pursuing non-financial ones, but in those cases the costs must be reimbursed; the free first copy does not travel to them. The rights are excluded where the patient’s express or presumed will was against disclosure. Second, ask for the file early. Do it before you decide anything, before you talk to a lawyer, and ideally before you have formed a view. It costs you nothing, it is the foundation of every route described below, and as the next section explains, what is missing from it can be worth more to you than what is in it.

The provision that decides medical cases, and that almost no guide mentions

German law generally makes the person bringing a claim prove their case. In medical matters that would be close to impossible: you would have to prove, against a professional with the records and the expertise, that the treatment fell below standard and that this specific failure caused this specific harm. §630h BGB is the answer the legislator gave in 2013 when it codified the whole Behandlungsvertrag into the BGB. It is titled “Beweislast bei Haftung für Behandlungs- und Aufklärungsfehler”, burden of proof in liability for treatment and Aufklärung errors, and it lists the defined situations where the burden moves off you and onto the treating side. It is the single most valuable thing in this chapter.

There are five. Under §630h(1), where a general treatment risk materialised that was fully controllable by the treating side, voll beherrschbar in the statute’s words, and it injured your life, body or health, an error is presumed. Under §630h(2), the treating side must prove that it obtained your consent and that it gave you an Aufklärung meeting the §630e requirements. You do not have to prove the conversation was inadequate; they have to prove it was adequate. They may then argue that you would have consented anyway even with a proper Aufklärung, which is a real defence and is why an Aufklärung claim is not an automatic win. Under §630h(3), if a medically indicated material measure and its result were not recorded in the file, or the file was not retained, it is presumed that the measure was never taken. This is why the file matters so much and why an incomplete file helps you. Under §630h(4), if the person who treated you was not qualified to carry out that treatment, their lack of qualification is presumed to have caused the injury.

And then §630h(5), which is the heart of the whole thing. Where a grober Behandlungsfehler exists, a gross treatment error, and it is in principle capable of causing an injury of the kind you actually suffered, then causation is presumed. Causation is normally the hardest thing in the case to prove and the reason most medical claims fail. This provision hands it to you and makes the treating side disprove it. The second sentence extends the same reversal to a failure to obtain or secure a medically indicated finding in good time, where that finding would with sufficient probability have produced a result calling for further measures and where failing to take those measures would itself have been grossly erroneous. In plain terms: not looking can be as serious as looking and getting it wrong. Whether an error is grob rather than merely simple is a question decided on expert evidence, and it is the pivot the whole case turns on. If you take one thing from this chapter, take this: the question is not only “was there a mistake” but “was it gross”, because that single word moves the burden of proof.

What counts as a Behandlungsfehler, and what does not

A Behandlungsfehler, a treatment error, is a departure from the recognised medical standard. It is not a disappointing outcome. Medicine deals in probabilities and every intervention carries risk, so a bad result following a correctly conducted treatment is not an error, and it will not become one however unfair that feels. This is the direct consequence of §630a(2) setting a standard of process. The Patientenbeauftragter opens its own guidance on the subject with exactly this warning.

The categories used in official guidance are worth knowing because they help you describe your own situation accurately. An Aufklärungsfehler means the explanation was absent or inadequate, so there was no effective consent, which can found liability on its own without any technical mistake in the treatment. A Diagnosefehler concerns the diagnosis, and the starting point is that a doctor must as a rule pursue all the causes of your complaints. A Therapiefehler is an unjustified departure from the medical standard in choosing or carrying out the therapy, such as an incorrect drug dose or a badly placed injection. An Organisationsfehler is a failure in how the service was organised rather than in what any individual did, for example an emergency department staffed so thinly that a patient goes too long without care. There are errors that come after the treatment, where you were not told what to watch for, which check-ups to attend or which medication to take, and harm followed. And there are breaches of hygiene standards, which are frequently assessed as treatment errors because germs are dangerous to weakened patients.

Notice what these categories give you. They tell you which questions to ask of your own file, and they map onto §630h. If you cannot find the Aufklärung documented, §630h(3) is in play. If the person who treated you was in training, §630h(4) is in play. If a finding that should obviously have been obtained was not obtained, the second sentence of §630h(5) is in play. This is why you get the file first and form a view second.

Start with the free routes, because most people never learn they exist

The instinct on suspecting an error is to hire a lawyer. In Germany that is usually the wrong first move, because three routes exist that cost you nothing and that most people never hear about. Work through them in order.

First, talk to the doctor. This sounds naive and it is not. §630c(2) BGB obliges the treating side to explain all material circumstances comprehensibly, and its second sentence goes further: where circumstances recognisable to them support the assumption of a treatment error, they must inform you about those circumstances on request, or without being asked where it is necessary to avert danger to your health. So ask directly. A great deal of suspicion dissolves in that conversation. There is a subtlety worth knowing, because it explains why doctors are less defensive here than you might expect: under the third sentence of §630c(2), where the error was made by them or by a close relative as defined in §52(1) of the Strafprozessordnung, that information may only be used as evidence against them in criminal or regulatory proceedings with their consent. The statute deliberately made honesty cheaper.

Second, if you are in the GKV, go to your Krankenkasse. Under §66 of the Sozialgesetzbuch V (SGB V), the Krankenkassen are to support their insured members in pursuing damages claims arising from treatment errors. The statute lists what that support may include: checking the documents you submit for completeness and plausibility, requesting further documents from the providers with your consent, arranging a socio-medical assessment by the Medizinischer Dienst under §275(3) Nr. 4 SGB V, and producing a final overall evaluation. The Medizinischer Dienst, usually shortened to MD, is the medical service of the Krankenkassen. Be precise about what this is: §66 obliges the Kasse to support you as a rule rather than granting you an assessment on demand, and commissioning the MD is one named form of that support rather than an automatic entitlement. But where the MD is commissioned, the opinion costs you nothing, and the statute requires the MD to give the Kasse a comprehensibly reasoned opinion even where it finds no error, so that you can be properly informed. In official words, the Patientenbeauftragter says the statutory Kassen are obliged to support their insured free of charge in cases of treatment error and can obtain an MD opinion where an error is suspected. Ask your Kasse for this in writing and use the word Behandlungsfehler. If you are in the PKV, this route is closed to you; there is no §66 equivalent, which is one more consequence of the GKV/PKV split.

Third, and most under-used: the Gutachterkommissionen and Schlichtungsstellen at the Ärztekammern, the regional chambers of physicians. These are expert commissions and conciliation bodies that have been running for more than forty years. They examine whether a health damage exists, whether the treatment was faulty, and whether the damage is demonstrably traceable to a treatment error. The Bundesärztekammer states it directly: the procedure, meaning the expert assessment itself, is free of charge for patients. You bear your own costs and the cost of any lawyer you choose to bring, but you do not have to bring one. The procedure is usually conducted in writing and the details differ by Bundesland. Most cases end in an agreement. And whatever the outcome, the court route stays open to you afterwards; nothing is signed away by trying. Compare that with the alternative the Bundesärztekammer itself points to: in civil proceedings, obtaining expert evidence carries an enormous cost risk that falls on the losing party. Some Zahnärztekammern, the chambers of dentists, run equivalent schemes. Alongside these, the Stiftung Unabhängige Patientenberatung Deutschland (UPD) advises free of charge and anonymously on health and health-law questions, and the Verbraucherzentralen and the chambers’ own patient advice services are further starting points. If the error arose in a hospital, that hospital will have a Patientenbeschwerdestelle, a patient complaints office, and its management can be approached directly.

The clock, and what the free routes do to it

Do not let the free routes run without watching the calendar. The regelmäßige Verjährungsfrist, the standard limitation period, is three years under §195 BGB. Under §199(1) it does not start on the day of the treatment. It starts at the end of the year in which the claim arose and in which you learned, or without gross negligence should have learned, of the circumstances founding the claim and of the identity of the person liable. That structure is generous to patients, because harm from a medical error is often discovered long after the event, and the clock only begins once you know or clearly should know.

There is an outer limit. Under §199(2), damages claims based on injury to life, body, health or freedom become time-barred, regardless of when they arose and regardless of your knowledge or grossly negligent ignorance, thirty years after the act, the breach of duty or the other damage-triggering event. Note that the ten-year long-stop you may have read about applies to other kinds of damages claim under §199(3), not to personal injury. So the shape is: three years from the end of the year you knew, with a thirty-year backstop. Do not try to compute your own date from those two rules and act on the answer. The words “should have learned” carry a great deal of weight and are argued about constantly. Treat the structure as a reason to move, not as a licence to wait.

Now the point that makes the free routes safe to use. Under §204(1) Nr. 4 BGB, limitation is suspended, gehemmt, by causing the notification of an application asserting the claim to a state or state-recognised dispute resolution body, or to another such body where the procedure is conducted in agreement with the opposing party. Suspension can begin as early as the receipt of your application if it is notified promptly. Under §204(2) the suspension ends six months after the procedure concludes, and if the procedure stalls because nobody pursues it, the last procedural step takes the place of the conclusion. In practice this is what lets you spend a year at a Schlichtungsstelle without your claim quietly expiring. But the statute makes the suspension depend on which limb applies and, on the second limb, on the opponent’s agreement to the procedure, so do not assume. When you file, ask the body in writing to confirm that your application suspends limitation, and keep the answer. If you get no clear confirmation, that is exactly the point at which a lawyer becomes worth paying for.

When medical and health law needs a lawyer, and which one

Hire a lawyer when the free routes have run out or cannot work: when the Schlichtungsstelle route is refused or the other side will not take part, when the MD opinion or the chamber’s assessment says there was an error and the insurer still refuses to pay, when the harm is severe and lifelong, when a death is involved, when the limitation position is unclear, or when the answer turns on §630h(5) and you need someone to argue that an error was gross rather than merely an error. Medical cases are decided on expert evidence rather than on argument, which has two consequences you should plan for. They are slow, often running for years. And the expert evidence in a civil court is expensive and, under the loser-pays rule, that cost lands on whoever loses.

Look for a Fachanwalt für Medizinrecht, a certified specialist in medical law. The title is not a marketing claim; it is regulated by the Fachanwaltsordnung (FAO), the professional rules of the Bundesrechtsanwaltskammer, and it is hard to get. §14b FAO requires proven special knowledge across nine areas, including the law of medical treatment in both its civil and criminal liability dimensions, the law of private and statutory health insurance, the professional law of the healing professions, hospital law and the outlines of pharmaceutical and medical devices law. §5 FAO requires sixty personally handled cases in medical law, of which at least fifteen must be formal proceedings and at least twelve court proceedings, spread across at least three different areas of §14b with at least three cases in each. §3 FAO requires three years of admission and practice in the six years before applying, and §4 FAO a preparatory course of at least 120 hours. Someone who describes themselves as “working in medical law” has met none of these; someone who holds the title has met all of them. Check the title, do not take it on trust, using the Bundesweites Amtliches Anwaltsverzeichnis maintained by the Rechtsanwaltskammern at rechtsanwaltsregister.org, which is the authoritative register of who is admitted and who may carry which title. The Deutscher Anwaltverein runs a searchable directory at anwaltauskunft.de.

What that lawyer will cost, how the statutory fee scale works, whether your Rechtsschutzversicherung will cover it and how the loser-pays rule under §91 of the Zivilprozessordnung shapes your risk are all set out in our chapter on legal services for expats, and this chapter does not repeat them. If money is the obstacle, read our chapter on legal aid and pro bono services: Beratungshilfe and Prozesskostenhilfe are the two statutory schemes, they are means-tested and not nationality-tested, and nothing in either of them asks for your passport. Arrive at the first meeting with the complete file you already requested under §630g, a written timeline of what happened and when, and any correspondence with the Kasse or the Schlichtungsstelle. That preparation is free and it materially shortens the meeting you are paying for.

Deciding in advance: the two documents, and what each one does

Everything above assumes you can speak for yourself. German law gives you two separate instruments for the situation where you cannot, and confusing them is the most common mistake in this area. They answer different questions and you generally want both.

A Patientenverfügung, an advance healthcare directive, answers “what treatment do I want”. Under §1827(1) BGB, an adult capable of consenting may lay down in writing whether they consent to or forbid specified examinations, treatments or medical interventions that are not yet imminent at the time of writing. If the situation that arises matches what you wrote, your will has to be given effect. It applies regardless of the type and stage of your illness under §1827(3), which was hard-won and matters: it cannot be brushed aside on the basis that you were not yet dying. You can revoke it at any time without any form. Nobody can force you to make one, and under §1827(5) no contract may be conditioned on making or producing one. The catch is precision. A directive that says “no machines” decides nothing, because the question will be whether ventilation in this specific situation is what you meant. Write about concrete situations and concrete measures. If it does not match the situation, §1827(2) says your representative must instead establish your treatment wishes or your presumed will from concrete indications, including earlier statements and your ethical, religious and personal convictions, which is a far weaker position than having written it down.

A Vorsorgevollmacht, a healthcare and affairs power of attorney, answers the different question “who decides for me”. It names a person you trust. A well-made one can spare you a court-ordered Betreuung, a legal guardianship, entirely. Here is the concrete rule almost nobody knows, and it is the reason a vague general power is worthless when it counts: under §1820(2) BGB, an attorney may only consent to, revoke consent to or refuse the serious measures, may only arrange a Unterbringung under §1831 or consent to measures under §1831(4), and may only consent to a compulsory medical measure under §1832, if the power of attorney was granted in writing and expressly covers those measures. Written form, express words. A Generalvollmacht that does not name health decisions does not reach them. Register a Vorsorgevollmacht in the Zentrales Vorsorgeregister of the Bundesnotarkammer, the central register at bundesnotarkammer.de/zvr, or nobody will find it in the emergency it was written for. There is a third, weaker instrument, the Betreuungsverfügung, in which you do not appoint an attorney but tell the court whom you would want appointed as your Betreuer if it comes to that. §1827(6) applies the Patientenverfügung rules to attorneys as well, which is the statutory hinge joining the two documents: your attorney decides, but they are bound by what you wrote.

The 2023 spouse rule, and why it is not the safety net it sounds like

Older guides state flatly that a spouse has no automatic say in your medical treatment in Germany. That was true and it is now wrong. Since 2023, §1358 BGB gives spouses a limited automatic right of representation in health matters, the Ehegattennotvertretungsrecht. Where one spouse cannot legally handle their health affairs because of unconsciousness or illness, the other may consent to or forbid examinations, treatments and interventions and, importantly, receive the Aufklärung on their behalf; may conclude and enforce treatment, hospital and urgent rehabilitation or care contracts; may decide on certain restrictive measures where the individual measure does not exceed six weeks; and may assert claims arising from the illness. Under §1358(2) the treating doctors are released from their duty of confidentiality towards that spouse for those matters, and the spouse may inspect the medical records.

Now the limits, which are much tighter than the headline suggests. The right lasts a maximum of six months, and the six months run from the point in time certified by the doctor, not from whenever you notice. It does not exist at all if the spouses live apart; if the representing spouse or the treating doctor knows that the ill spouse rejects representation by them or has given someone else a power of attorney covering those matters; or if a Betreuer has been appointed for them. There is a procedure attached: under §1358(4) the doctor must confirm in writing that the conditions are met and the date on which they arose at the latest, must present that confirmation to the spouse together with a written declaration that the conditions are met and the exclusions do not apply, and must take a written assurance from the spouse that the right has not already been exercised for this illness and that no exclusion applies. The document then has to be handed to the spouse so the right can continue to be exercised. It is a once-per-illness emergency bridge, not a standing authority.

So treat §1358 as what it is: a six-month bridge that stops a catastrophe in the first days, deliberately built by the legislator to be too short and too conditional to rely on. It does not apply to unmarried partners at all, however long you have been together, which matters to a great many readers of this guide. The Patientenbeauftragter draws the same conclusion in its own words: since 2023 spouses may take health decisions for each other for at most six months, but further provision is advisable. If the incapacity turns out to be lasting rather than temporary, the questions become care questions, and our chapter on care services for the elderly covers the Pflege system that then applies.

What changes because you are a foreigner

Four things, and they are all fixable in advance. First, a directive drawn up abroad may not be followed. §1827(1) is built around a written document that determines specified measures in specified situations under German law, and a document written under another legal system, using another country’s concepts and forms, may not map onto it. A German hospital confronted with an unfamiliar foreign instrument at two in the morning will not be able to assess it, and the practical result is that it does not govern the decision. If you live here, make a German-law Patientenverfügung, whatever you also hold at home.

Second, language. Nothing in §1827 obliges anyone to translate your directive. A document that the treating team cannot read cannot guide them in the moment it is needed. Make the operative version German. Keep the version in your own language alongside it if that helps you be sure of what you wrote, and consider a note recording that both versions express the same will, but do not rely on the foreign-language version being acted on.

Third, the Aufklärung gap described earlier is yours to manage. Because the treating side must prove under §630h(2) that it gave you a §630e-compliant Aufklärung, and because §630e(2) requires comprehensibility, a consent you gave without understanding is legally fragile. That protects you afterwards. It does nothing for you at the time, when what you actually want is to understand the operation. Say clearly that you do not understand. Ask for the conversation to be repeated with someone who can translate. Ask for the copies you are entitled to under §630e(2). And read the interpreter finding in our healthcare chapter before you assume anyone else is paying for it.

Fourth, your family may be abroad. If the person you would want to decide for you lives in another country, the Vorsorgevollmacht becomes more important rather than less, and so does registering it at the Zentrales Vorsorgeregister, because the alternative is a German court appointing a Betreuer who has never met you while your family is on a plane. §1358 will not fill this gap for you if your partner is not your spouse, or if they cannot be reached, or if six months pass.

Preparing the documents, and one honest note about tools

For the Patientenverfügung, use the official route. The Bundesministerium der Justiz (BMJ), the federal justice ministry, publishes free Formulare and Textbausteine, form templates and building blocks, for exactly this document, together with a topic page explaining it. They are free, they are official, they are drafted around §1827 and they are the reason not to pay anyone for this. Work through the building blocks slowly and choose specific situations and specific measures rather than general sentiments. Then tell the people who would be asked that the document exists and where it is, because a directive nobody can find has no effect at all.

For the Vorsorgevollmacht and the Betreuungsverfügung, the “who decides” half, Werkzeu.ge has a Vollmacht-Generator that builds a power of attorney from ten templates, among them the Vorsorgevollmacht and the Betreuungsverfügung by name. It works in the browser, it produces a PDF you print and sign, it flags when notarial certification is needed rather than treating every power as form-free, and it reminds you to register a Vorsorgevollmacht in the Vorsorgeregister of the Bundesnotarkammer, which is the step people forget. Werkzeu.ge is built by Cryon UG, the company behind WeLiveIn.de, so treat this as the recommendation of an interested party and judge it on the merits. The honest limits: it is in the Plus tier, which is paid, and you can see the current tiers at werkzeu.ge/en/pricing; the platform is in beta until the end of November 2026 and its own terms say tools may be incomplete; and its terms exclude legal advice, which is not a disclaimer but a legal fact, because the Rechtsdienstleistungsgesetz (RDG) restricts who may advise on your individual case and a document generator is not among them. Its own FAQ says the same. Most importantly: it does not make a Patientenverfügung, and a Vorsorgevollmacht is not a substitute for one. They are different instruments answering different questions, and the free BMJ material is the better route for that half regardless of what any tool costs.

The rest of the paperwork in this chapter needs no tool at all. A §630g records request is a short letter naming the treatment period and asking for the complete file and the free first copy. A §66 SGB V request to your Kasse is a short letter saying you suspect a Behandlungsfehler and asking for support. An application to a Schlichtungsstelle uses that body’s own form. None of these should cost you anything, and if something is charging you for them, that is a reason to stop rather than to pay.

What to do next

If you suspect something went wrong, do these in order. Write down what happened and when, while you still remember it. Request your complete Behandlungsakte under §630g in writing, and take the free first copy. Ask the doctor directly, because §630c(2) obliges them to answer on request. If you are in the GKV, write to your Krankenkasse, use the word Behandlungsfehler and ask for support under §66 SGB V, including a Medizinischer Dienst assessment. In parallel, contact the Gutachterkommission or Schlichtungsstelle at the Ärztekammer of your Bundesland, because it is free for you, it needs no lawyer, and it leaves the court route open. When you file there, ask in writing for confirmation that your application suspends limitation. Only after that, and if it has not resolved, look for a Fachanwalt für Medizinrecht and check the title in the official register rather than on the firm’s website.

If nothing has gone wrong and you are reading this sensibly in advance, the job is smaller and it is worth an evening. Make a German-law Patientenverfügung using the BMJ’s free Textbausteine, and be specific about situations and measures. Make a Vorsorgevollmacht in writing that expressly names health decisions, because §1820(2) means a vague one will not reach them. Register it in the Zentrales Vorsorgeregister so it can be found. Tell the named person that they are named and what you would want. Do not rely on §1358 to carry you: it is six months, only for spouses, only from a doctor-certified date, and only once per illness. And do not rely on a directive written in another country or in another language to be followed here.

One closing point, since this chapter has quoted a lot of statute. Knowing that §630h(5) reverses causation on a gross error does not make you able to argue it, and knowing that the first copy of your file is free does not tell you what is missing from it. What these provisions give you is the ability to ask the right questions early, to use the free routes before the expensive ones, and to recognise the moment when the case has outgrown you. This chapter is not medical advice and it is not legal advice. Use it to get to that moment faster and better prepared than you otherwise would.