[Ethical problems in psychiatric intervention in hopeless conditions in patients under the care of somatic specialists].

Psychiatric intervention is usually requested for patients in other hospital departments in case of exacerbation of an intercurrent mental disease, in case of the development of a symptomatic mental disorder directly associated with the basic disease, and finally in case the patient refuses to cooperative with the attending staff. If in the former two indications the psychiatric intervention has a causal or complementary character in the latter the psychiatrist either makes up for the deficit of professional ethics of another specialist, provides an alibi for his possible failure, or objectively the sequelae ensuing from refusal of the intended intervention. The decision of the psychiatrist is influenced more by legal norms and general finally decides with forensic responsibility on the ability of the patient to evaluate ethic principles than evaluation of actual psychopathology. The results must, however, always be based on a spotless professional approach oriented on the mental health or the patient and his right to decide on his own integrity. Case--histories demonstrate the complexity of this decision and responsibility transferred often to the psychiatrist.