Patientenverfügung und Behandlungsvereinbarung als Instrumente der Vorausplanung in der forensischen Psychiatrie

Definition of the problem In Germany as well as in many other countries, mentally ill criminals who are not guilty by reasons of insanity can be sentenced to psychiatric treatment in forensic clinics. In 2011, the German Constitutional Court substantially strengthened these patients\’ right to self-determination in case of treatment refusal. Arguments In this context, we discuss the significance of instruments of advance healthcare planning. First, we describe the context of psychiatric treatment in forensic clinics and the changes the new German legal regulations brought about. A case study helps to illustrate the consequences of treatment refusal for both patient and healthcare personnel. Conclusion Eventually, we discuss if and how advance directives and joint crisis plans can be useful in forensic clinics and how additional measures can help to facilitate patient self-determination.