The professional society could also see the decision of the Federal Constitutional Court on triage as a defeat, after all, the successful constitutional complaint by disabled citizens was also directed against the guidelines of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI).

In the "Decisions on the allocation of intensive care resources in the context of the Covid 19 pandemic", DIVI, together with other specialist societies, formulated criteria last year according to which doctors in intensive care units should decide who, in the event of a shortage of treatment options, is best can get life-saving therapy.

Kim Bjorn Becker

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The patient's state of health plays a role in the document, but also possible comorbidities and the general prospect of ultimately successful treatment - for the constitutional judges, the protection of disabled people could so quickly fall behind. Too fast. But at DIVI, the decision from Karlsruhe is seen more as confirmation than as criticism. The DIVI announced on Tuesday that the guideline was to be checked after the verdict to determine whether “further clarifications” are necessary.

There, however, one reads the judgment mainly as follows: Possible disadvantages for the disabled could most likely result from "the fact that the recommendations are not followed appropriately in practice". It is a matter of training medical staff to ensure that the Directive is applied as the professionals intend. The current guideline expressly states that prioritization is not permitted “due to calendar age, due to social characteristics or due to certain underlying illnesses or disabilities”.

But since many disabilities are accompanied by certain comorbidities, the differentiation in practice is often not as easy as it is on paper. The Karlsruhe judges therefore criticized the fact that the guideline “does not eliminate” possible disadvantages for disabled people and, due to the lack of discriminatory precision, could even become a “gateway” for discrimination. "We do not hope that the legislature will now make medical requirements," said Uwe Janssens, a member of the DIVI Presidium, the Reuters news agency. "He cannot do that because he is actually not on the medical route."

The Munich medical ethicist Georg Marckmann said in an interview with the FAZ that everything had already been done to reduce risks.

It is unclear to him "how the legislature can make a regulation that is not subject to the risk of incorrect application in the same way as the recommendations of the specialist societies".

A residual risk will always remain, because where people acted under time pressure, they also make mistakes.

"The elements of a possible regulation proposed by the Federal Constitutional Court - the principle of multiple control, requirements for documentation, training and further education - have already been largely taken into account by the specialist societies."

The Medical Association refers to their guidance

Of course, doctors' representatives repeatedly emphasize that no life should be worth more than another.

In its reaction to the judgment, the German Medical Association recalled its guidance for doctors from May of last year on Tuesday.

It says: "Disadvantages based on, for example, age, gender, nationality, disability or social status."

The judges had emphasized the "factual laws of clinical practice", that is, the need to make therapeutic decisions quickly.

Therefore, the Medical Association is now appealing to the parliamentary groups in the German Bundestag to involve doctors closely in the upcoming legislative process.

The German Hospital Society said it was to be welcomed that the Constitutional Court was demanding more precise information on triage.

Such decision-making aids could “support doctors in their work on site and provide legal security”.

Representatives of the disabled expressly praised the decision of the Karlsruhe judges.

"A year ago we called for such a legal regulation to be necessary," said the federal chairman of the Lebenshilfe association, the former Federal Minister of Health Ulla Schmidt.

"The Federal Constitutional Court correctly pointed out that there is a risk that people with disabilities will be disadvantaged, since the disability generally implies a lower chance of survival."