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Health

Bundestag passes bill on involuntary treatment

The German parliament has voted to permit the involuntary treatment of patients. While psychiatrists have welcomed the move, those affected criticize it as legitimizing torture, and say a living will is the solution.

There are many psychiatric patients, who Jutta Muysers, head of a big psychiatric clinic in the West German city of Langenfeld, has been unable to treat. Often, she told DW, patients are released without adequate treatment.

Last summer, the German Federal Court ruled against compulsory treatment of patients with psychiatric problems. It argued that there was no legal basis to commit patients to treatment against their express wishes. Ever since, many of Muysers and her team have had to follow their patients wishes.

Now, however, the ruling coalition has passed a law which provides a legal framework for these treatments. The bill, which was passed on January17, was supported by opposition parties. Only the Left party voted against the bill.

The rights of psychiatrists strengthened

An image showing a fenced mental health facility

More than 1.2 Germans are put away in mental health facilities

Muysers said she was in favor of the law. “At the moment, there is no legal basis. So everyone thinks they know it best – be it patients, their relatives or psychiatrists.” Muysers now hopes for clear rules to which psychiatrists can adhere.

Muysers admits that many patients don't agree to a treatment with psychotropic drugs deemed necessary by doctors. But she defends compulsory treatments, saying that not every patient is able to assess what is the best treatment. “Some patients hear voices or are so paranoid that these fears take such center-stage that they are unable to assess the situation.”

More than 140,000 people are committed to psychiatric wards for compulsory treatment in Germany every year – putting Germany in second place behind France.

Sharp criticism from those affected

Matthias Seibt calls compulsory treatment “torture.” The 53-year old was treated against his will several decades ago. He was given strong anti-psychotic drugs, which are “dangerous” drugs, according Seibt, who himself is a psychiatrist. The drugs, he told DW, can shorten a patient's life-expectancy by up to 30 years.

 “If someone says: ‘No, I don't want to be treated,' then we should respect that person's wishes.”

He says the bill discriminates against psychiatric patients. “That is a clear breach of the German constitution, the Federal Court's ruling and the UN Convention on the Rights of People with Disabilities.”

The German Institute for Human Rights has criticized the bill for the same reasons.

Matthias Seibt says all psychiatric wards are “terror systems”, aiming at breaking a patients' will. He says the only solution is to withdraw all public funds from psychiatric clinics.

Is a living will the solution?

An image showing a patient filling in a living will (Photo:Thomas Kienzle/AP)

Living wills can help patients, in the event they become too ill

Rainer Richter, who heads the Federal Association of Psychiatrists, disagrees. “It's not torture. To call our treatment torture is to overly dramatize it.” He stressed that compulsory treatment was not about black-mailing patients.

But Richter would like to see a more comprehensive bill. He said more staff and better care for psychiatric patients are necessary.

He would also like to see the addition of patient contracts - so-called living wills -which are not included in the bill. This would allow patients to decide in writing how they would like to be treated in the event that they were unable to to make that decision at a later date.

"We would like it to be mandatory for hospitals to make this available to patients," Richter says. In that way, you coul ensure that patients will be treated should they be committed, he added.

Jutta Muysers also believes these contracts are a good solution because, above all, she knows how sensitive the issue is.

"No one wants to be treated against their will. The difficulty for psychiatrists is that we don't say to the patient, 'your leg is broken, it has to go into a plaster,' instead, we say, 'your thoughts are not right,' and that is of course difficult to understand."

So she has already been trying to discreetly to agree on treatments with patients, in the event they are unable to decide on their own.

DW.DE