treatment contract

§ 630 Contractual obligations in the treatment contract
(1) By the treatment contract, the one who agrees on the medical treatment of one patient (treating), to the performance of the promised treatment, the other part (patient) to the agreed remuneration, unless a third party is obliged to pay.
(2) Treatment must be in accordance with generally accepted professional standards in force at the time of treatment, unless otherwise agreed.
 
§ 630b Applicable regulations
The employment relationship shall be governed by the employment relationship, which is not an employment relationship within the meaning of § 622, unless otherwise specified in this subheading.
§ 630c Participation of the parties; information requirements

(1) The treating physician and the patient should cooperate to perform the treatment. (2) The clinician is required to clearly explain to the patient at the beginning of the treatment and, as necessary, during the course of any treatment relevant circumstances, in particular the diagnosis , the expected health development, the therapy and the measures to be taken during and after the therapy. If the treating circumstances justify the acceptance of a treatment error, he must inform the patient about these on request or to avert health hazards. If the treating person or one of his family members referred to in § 52 Paragraph 1 of the Code of Criminal Procedure has made a mistake, the information under sentence 2 may only be used for evidence in a criminal or fine procedure against the treating person or against his relatives with the consent of the treating person.

(3) If the clinician knows that full coverage of treatment costs by a third party is not assured, or, if circumstances permit, sufficient guidance, he must inform the patient of the likely cost of treatment in text form prior to treatment. Further form requirements from other regulations remain unaffected.
(4) The information of the patient is not required, as far as this is exceptionally dispensable due to special circumstances, especially if the treatment is urgent or the patient has expressly waived the information.
§ 630d consent
(1) Before carrying out a medical procedure, in particular an intervention in the body or the health, the treating person is obliged to obtain the consent of the patient. If the patient is incapacitated for consent, the consent of a person entitled to do so must be obtained unless a living will is permitted or prohibited in accordance with § 1901a, 1 sentence 1. Further requirements for the consent from other regulations remain unaffected. If consent for an urgent action can not be obtained in time, it may be given without consent if it meets the patient's presumed will.
(2) The effectiveness of the consent presupposes that the patient or, in the case of paragraph 1 sentence 2 the person entitled to consent has been informed prior to consent in accordance with § 630e paragraph 1 to 4.
(3) The consent can be revoked informally at any time and without giving reasons.
§ 630e disclosure obligations
(1) The treating physician is obliged to inform the patient about all circumstances that are essential for consent. These include, in particular, the nature, extent, execution, expected consequences and risks of the measure and their necessity, urgency, suitability and chances of success with regard to diagnosis or therapy. Education should also indicate alternatives to the measure if several medically equally indicated and common methods can lead to significantly different pressures, risks or chances of recovery.

(2) The Enlightenment must

1.
orally by the treating person or by a person having the necessary training to carry out the measure; in addition, reference may be made to documents which the patient receives in text form,
2.
done in a timely manner so that the patient can make informed decisions about consent,
3.
be understandable to the patient.

The patient must be provided with copies of documents he has signed in connection with the information or consent.

(3) It is not necessary to inform the patient as far as this is exceptionally unnecessary due to special circumstances, in particular if the measure can not be postponed or if the patient has expressly renounced the information.
(4) If, according to § 630d section 1 sentence 2, the consent of an authorized party is to be obtained, this must be clarified in accordance with paragraphs 1 to 3.
(5) In the case of § 630d paragraph 1 sentence 2, the essential circumstances under paragraph 1 are also to be explained to the patient according to his understanding, as far as his level of development and his understanding of it is able to take the explanation, and to the best of his own convenience does not conflict. Paragraph 3 applies accordingly.
§ 630f Documentation of treatment
(1) The treating physician is obliged to keep a medical record in paper form or electronically for the purpose of documentation in immediate temporal connection with the treatment. Corrections and changes to entries in the patient file are only permitted if it is clear from when they were made, in addition to the original content. This is also to be ensured for electronically led patient files.
(2) The practitioner is required to record in the patient record all measures and outcomes relevant to the current and future treatment, in particular the history, diagnoses, examinations, test results, findings, therapies and their effects, interventions and their effects. Consents and explanations. Medical reports are to be included in the patient record.
(3) The practitioner must keep the patient record for a period of ten years after the end of treatment, unless different retention periods exist under other provisions.
§ 630g Inspection of the patient's file
(1) Upon request, the patient is to be granted immediate access to the complete patient record relating to him, as long as the inspection does not conflict with any significant therapeutic reasons or other substantial rights of third parties. The refusal of the inspection must be justified. § 811 is to be applied accordingly.
(2) The patient may also request electronic transcripts from the patient record. He has to reimburse the treating person for the costs incurred.
(3) In the event of the death of the patient, the rights under paragraphs 1 and 2 are reserved for his heirs in the interests of the interests of property. The same applies to the next relatives of the patient, insofar as they assert immaterial interests. The rights are excluded, as far as the inspection opposes the explicit or presumed will of the patient.
§ 630h Burden of proof for liability for treatment and reconnaissance errors
(1) A mistake of the treating person is presumed, if a general treatment risk was realized, which was fully controllable for the treating person and which led to the injury of the life, the body or the health of the patient.
(2) The practitioner has to prove that he has obtained a consent in accordance with § 630d and has informed him in accordance with the requirements of § 630e. If the explanation does not meet the requirements of § 630e, the treating person can claim that the patient would have consented to the measure even if he had been properly informed.
(3) If the treating person has not recorded a medical essential measure and its result contrary to § 630f paragraph 1 or paragraph 2 in the patient record or has not kept the patient record against § 630f paragraph 3, it is presumed that he did not take this measure ,
(4) If a practitioner was unfit for treatment, it is believed that the lack of aptitude for the onset of injury to life, body or health was the cause.
(5) If there is a gross treatment error and this is in principle suitable to cause injury to life, body or health of the type actually occurred, it is assumed that the treatment error was the cause of this injury. This shall also apply if the practitioner has failed to raise or secure a medically required finding in good time if the finding was sufficiently likely to produce a result which would have given rise to further action and if the omission of such measures was grossly flawed would have been.
 
 
 
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