[Involuntary treatment under guardianship law in psychiatric hospitals in Germany: results of an online survey].

Aim Of The Study: To determine the circumstances of involuntary treatment under the German Civil Code (BGB) in psychiatric hospitals serving a catchment area.

Method: Medical directors of psychiatric hospitals in Germany, including psychiatric departments at general hospitals and university clinics, were interviewed by means of an online survey.

Results: The response rate among the N=397 institutions addressed was 43%.

Unveiling Usage Patterns and Explaining Usage of Symptom Checker Apps: Explorative Longitudinal Mixed Methods Study.

Background: Symptom checker apps (SCA) aim to enable individuals without medical training to classify perceived symptoms and receive guidance on appropriate actions, such as self-care or seeking professional medical attention. However, there is a lack of detailed understanding regarding the contexts in which individuals use SCA and their opinions on these tools.

Objective: This mixed methods study aims to explore the circumstances under which medical laypeople use SCA and to identify which aspects users find noteworthy after using SCA.

[Advance care planning for the end of life: How prepared are homes for adults with disabilities in Bavaria?].

Introduction: Autonomy at the end of life is associated with the ability to make self-determined decisions. The heterogeneous field of inpatient integration assistance poses particular challenges in this context. Advance care planning (ACP) is now available to people with disabilities.

[Advance directives and mental disorders: a practice recommendation of the Commission for Ethics and Law of the German Association for Psychiatry, Psychotherapy and Psychosomatics].

Background: Since the creation of legal requirements for advance directives by the legislator in 2009, special aspects of their application in the treatment of people with mental illnesses have been discussed.

Goal Of The Paper: Important questions on dealing with advance directives in everyday life will be answered in a practice-oriented manner.

Results: Among other things, this document answers the question of the conditions under which a patient can refuse or consent to hospitalization and treatment in advance, and in particular how to deal with advance directives whose implementation would also affect the rights of third parties.

"That's just Future Medicine" - a qualitative study on users' experiences of symptom checker apps.

Background: Symptom checker apps (SCAs) are mobile or online applications for lay people that usually have two main functions: symptom analysis and recommendations. SCAs ask users questions about their symptoms via a chatbot, give a list with possible causes, and provide a recommendation, such as seeing a physician. However, it is unclear whether the actual performance of a SCA corresponds to the users' experiences.

[Knowledge and misconceptions on advance directives-results of a citizen survey].

Background: Advance directives (ADs) such as living wills or healthcare powers of attorney are important tools to anticipate medical treatment decisions when decision-making capacity is lost in the future. Although a rising number of citizens in Germany are creating such documents, little is known about their knowledge of the purpose, types, and use of ADs. After more than 10 years since legislation on ADs came into force, this study intends to measure the objective knowledge of citizens and detect deficits in knowledge.

[What do health care professionals know about advance directives?].

Background: Advance directives are important to preserve the autonomy of patients for future situations in which they are uncapable of expressing their will. They are considered helpful by many healthcare professionals in their professional practice. However, their knowledge on these documents is not well known.

[Familiarity with and Dissemination of Advance Directives in Germany: Results of a Representative Survey of the General Population].

With an advance directive, people can make provisions for the case of incapacity to give consent with regard to future medical and nursing treatment decisions. Currently, there are no data available on how well known and widespread advance directives are in the population in Germany. The aim of the study was, in addition to record awareness and dissemination, to find out more about the reasons for (not) writing an advance directive and about information and support used by people.

[Are too Many Temporarily Placed Non-culpable Offenders Committed to Forensic Psychiatric Hospitals in Germany? Thoughts on the Relationship of Forensic and General Psychiatry].

From the perspective of the forensic clinics, the judiciary is increasingly ordering temporary placements according to Sec. 126a of the Code of Criminal Procedure. Three hypotheses are proposed that could (partly) explain this increase: 1) Courts' tendency to hand down this decision even in cases involving minor offences.

[Public mental health and patient autonomy-an area of conflict?].

Public mental health (PMH) interventions aim to promote and improve the well-being of members of a society. PMH is based on a normative understanding of what well-being is and what factors contribute to it. Without necessarily disclosing it, measures of a PMH program may affect the autonomy of individuals if their personal perceptions regarding their own individual well-being differ from PMH's prescriptions for well-being oriented toward societal goals.

[Factors of endangering and violation of autonomy in residential nursing homes: results of a scoping review].

Background: Respecting autonomy is one of the guiding principles of medical and nursing ethics. Nursing home residents represent a particularly relevant target group whose autonomy can be endangered or violated.

Aim: The study aimed to identify factors that endanger or violate the nursing home residents' autonomy and to determine specific life situations and contexts in which these factors are located.

[Generalist palliative care in hospitals during the first wave of the COVID-19 pandemic].

Background: In the research network of German university palliative care centers (PallPan), as part of Network University Medicine (NUM), recommendations for action were developed in regard to the care provided for seriously ill and dying patients during a pandemic. For this purpose, the experiences and needs of hospital staff working closely with patients outside of specialized palliative care units during the first wave of the COVID-19 pandemic were also examined.

Materials And Methods: Nationwide online survey of 8,882 physicians, nurses and therapists working in acute inpatient care in the period from December 2020 to January 2021 by means of a newly developed and piloted questionnaire on changes, burdens and cooperation with specialized palliative care.

Ethical, legal, and social aspects of symptom checker applications: a scoping review.

Symptom Checker Applications (SCA) are mobile applications often designed for the end-user to assist with symptom assessment and self-triage. SCA are meant to provide the user with easily accessible information about their own health conditions. However, SCA raise questions regarding ethical, legal, and social aspects (ELSA), for example, regarding fair access to this new technology.

[The reform of guardianship law].

The reform of the guardianship law has been decided! The reform will come into force on 1 January 2023. The content of the guardianship law will not be completely restructured. The tense relationship between the protection of the person against decisions not made on his or her own responsibility and the self-determination of the person will be consistently further considered and strengthened in favor of the self-determination of the person concerned.

Ethical, Legal, and Social Implications of Symptom Checker Apps in Primary Health Care (CHECK.APP): Protocol for an Interdisciplinary Mixed Methods Study.

Background: Symptom checker apps (SCAs) are accessible tools that provide early symptom assessment for users. The ethical, legal, and social implications of SCAs and their impact on the patient-physician relationship, the health care providers, and the health care system have sparsely been examined. This study protocol describes an approach to investigate the possible impacts and implications of SCAs on different levels of health care provision.

[«State of the Art» on Advance Directive Consultations].

«State of the Art» on Advance Directive Consultations Living wills serve to preserve self-determination at the end of life. They are intended to give patients the opportunity to intervene in their own treatment even if they are no longer able to do so because they are incapable of giving consent. In clinical practice, it is important, particularly in the case of serious illnesses such as cancer, not to work solely with general or standardized directives, but to seek formulations that are as individually suitable as possible.

[The Autonomy of Patients in Inpatient Medical Rehabilitation - Aspects of Endangerment and Preservation].

Purpose: The aim of the study is to identify aspects within inpatient medical rehabilitation that may endanger or preserve the autonomy of patients.

Methods: A scoping review was carried out on the basis of the current state of scientific knowledge. The methodological approach was based on the specifications of the Joanna Briggs Institute.

[Living wills of residents in nursing homes - which treatment situations and treatment measures are decreed?].

Background: The possibility of using a living will to influence later treatment in the event of incapacity to consent is nowadays an important element in safeguarding patients' autonomy at the end of life. Refusing or consenting treatment measures in advance of treatment is of particular importance for nursing home residents, not only against the background of the COVID-19 pandemic.

Methods: We conducted a survey of all resident-documents in 13 nursing homes of different sizes and service providers in the city and district of Wuerzburg.

[Changes in the Practice of Involuntary Hospitalization During the COVID-19 Pandemic - Experiences and Opinions of Chief Psychiatrists].

Objective: To collect experiences and opinions of chief psychiatrists in relation to changes in the practice of involuntary hospitalization during the COVID-19 pandemic.

Methods: Online survey among members of the Association of Chief Physicians for Psychiatry and Psychotherapy in North Rhine-Westphalia (LLPP) and analysis of protocols of LLPP board meetings.

Results: Changes in the practice of involuntary hospitalization have been perceived in contexts with and without direct reference to COVID-19.

Wishes and needs of nursing home residents and their relatives regarding end-of-life decision-making and care planning-A qualitative study.

Aims And Objectives: To explore wishes and needs, such as existing and preferred communication processes, of residents and relatives regarding medical and nursing planning at the end of life.

Background: Nursing home residents are a relevant target group for advance care planning (ACP) due to their high age and multimorbidity. Their relatives seem to be important partners in terms of communication and their documentation of wishes and needs.

[What replaces the locked door? : Conceptual and ethical considerations regarding open door policies, formal coercion and treatment pressures].

Background: Mental health professionals use various strategies to prevent involuntarily committed persons from absconding under an open door policy.

Objective: To provide an ethical framework for the evaluation of the replacement of locked ward doors by formal coercion or treatment pressures.

Methods: Empirically informed conceptual and ethical analysis.

Risks and errors in medicine. Concept and evaluation of an optional study module with integrated teaching of ethical, legal and communicative competencies.

The presentation and discussion of the content, methodology and evaluation results of a course on "Risks and Errors in Medical Science", adopting an integrated approach for the teaching of ethical, legal and communicative aspects. Written, structured evaluation using the adapted evaluation form "Evasys" as well as open questions on positive and negative aspects of the course and assessment of the effects thereof from the participants' viewpoint. The free text responses are evaluated according to the principles of qualitative content analysis.