BGH calls for a comparative assessment of the consequences of serious interventions
Alternative methods of treatment are legally permissible and therefore cannot be considered faulty from the outset. In particular in the case of serious interventions, doctors must then also have an eye on conventional medicine and weigh the consequences with their treatment options, the Federal Court of Justice (BGH) in Karlsruhe demanded in a judgment published on Monday, July 24, 2017 (file number: VI ZR 203 / 16).
In the specific case, it is about a treatment of "holistic dentistry", which takes a closer look at the effects of problems in the mouth on the entire body. During a “focus and interference field test”, the dentist found that protein inflammatory toxins enter the body from inflammatory foci of the teeth - from the right half of the head to the lower abdomen. The bone of the right upper jaw is insufficiently supplied with nutrients and there is a "silent tissue death in the bone marrow".
As a therapy, the dentist advised to remove all molars in the upper jaw and to mill out the jawbone thoroughly. The patient agreed to these measures. She later picked up the prescribed prosthesis from the dental laboratory herself, without having its seat checked and without receiving any instruction.
Because of difficulties with the dentures, the patient went to another dentist. This was very critical of the treatment by the colleague.
With her lawsuit, the patient demands reimbursement of the fee paid, reimbursement of follow-up treatment costs and a compensation for pain and suffering of at least 5,000 euros.
The regional court and the higher regional court (OLG) largely granted this.
With its judgment of 30 May 2017, which has now been published in writing, the BGH overturned the preliminary decisions and referred the dispute back to the OLG Zweibrücken for review. The previous instances were based on an expert who, according to his own statements, is not familiar with the basics of holistic dentistry. In such cases, however, this is necessary.
Because the use of not generally recognized forms of therapy is "legally permitted in principle", emphasized the Karlsruhe judges. As long as the patients know the scope of their decision, they could "choose any treatment that is not contrary to good morals". An alternative treatment approach could therefore “not be used to infer a treatment error from the start”
With such a treatment, doctors would always have to weigh the advantages and disadvantages for the specific patient. They should also have an eye on the possibilities of conventional medicine. "The more severe and radical the intervention in the patient's physical integrity, the higher the demands on the medical justification of the chosen treatment method," emphasized the Karlsruhe judges.
Here the treatment had significant consequences. The patient could no longer chew properly without a prosthesis, and implants could no longer be inserted into the milled jaw.
The defendant dentist rightly criticized the choice of the expert. The commissioned expert himself suggested two colleagues who are also familiar with holistic dentistry. Because he himself could not judge whether it was a reasonable treatment based on their approach. mwo