Abstract
Before initiating examination, treatment or care, the patient’s informed consent must be obtained. This is a central principle in health law. If the patient is incapable of giving his consent, it becomes an issue whether the necessary consent can be given by proxy. In case of an emergency the doctor can, when the patient is incapable of taking a stand, in certain situations, act without consent. Authority to act directly against the will of the patient — to use force — requires an explicit legal authorisation, and a such exists only in exceptional cases.1
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Notes
Statutory basis for compulsory treatment exists in the psychiatry act (Statutory Order no. 849 of 2 December 1998 on detention and other kinds of restrain in psychiatry) and in the epidemic act (act no. 114 of 21 Marts 1979 on measures against epidemic diseases).
Statutory Order no. 632 of 20 July 1995 on practising medicine.
Act no. 482 of 1 July 1998 on patients’ rights.
In the act the concept “member of the health profession“ is introduced. By this is meant persons who are authorized by special legislation to be in charge of professional health responsibilities and persons acting under their responsibility, cf. ARP.
In pursuance of the act on patients’ rights the following statutory orders and guidance notes are issued: 1) Statutory Order no. 663 of 14 September 1998 on living wills 2) Circular no. 157 of 15 September 1998 on physicians’ obligations with regard to living wills etc. 3) Statutory Order no. 158 of 15 September 1998 on physicians’ obligations with regard to the content of living wills. 4) Statutory Order no. 665 of 14 September 1998 on informed consent and on disclosure of health information etc. 5) Guidance note no. 161 of 16 September 1998 on informed consent and on disclosure of health information etc. 6) Guidance note no. 155 of 14 September 1998 on right of access to health documents.
Latest: Statutory Order no. 69 of 8 January 1999 on the Ethical Review Committee and Biomedical Research-projects Act.
Act no. 402 of 13 June 1990 on the inquest, autopsy and transplantation etc.
Section 6 of the act on practising medicine.
Including cases where it would seem “unnatural“ to require the patient’s explicit consent.
Guidance note no. 161 of 16 September 1998 on informed consent and on disclosure of health information etc.
Statutory Order no. 665 on informed consent and on disclosure of health information etc.
Guidance Note no. 161, item 2.1.2.1.
Act no. 388 of 14 June 1995.
A “member of the health profession“ is defined by APR as a person who, by legislation, is authorized to be in charge of professional health responsibilities and persons acting under their responsibilities, (section 4).
To the local health authorities the community physicians represent the state. They supervise the health staff, give assistance to the courts and the police, etc.
Guidance Note no. 161, item 2.1.2.1.
The disease, anorexia nervosa, which is the most frequent form of sitophobia, mostly affects youngsters. Only if the physician assesses that special psychiatric conditions for compulsory treatment are met, will the health staff be authorized to force-feed a 15 year old girl who is considered capable of understanding the consequences of her refusal to eat.
See Guidance Note no. 161 on informed consent and on and on disclosure of health information etc., item 2.1.1.
There is also a general obligation to act in certain situation according to the Danish Criminal Code. This obligation applies to everybody.
The Sanitation Authorities’ Patient Complaint Board is a central decision making body which deals with complaints on medical activities exercised by persons within the health services. The board makes decisions in concrete cases where a patient or a relative files a complaint to the board.
See also Guidance note no. 161 on informed consent, item 2.3. where it is stated that except from living wills, it is not possible to state one’s treatment wishes in advance regarding a possible future situation in which one is not capable of making a decision.
National Board of Health has issued a Guidance Note of 6 December 1995 on continuing intravenous infusions of opiates to terminal patients.
In the explanatory notes to the provisions on informed consent, which were added to the Act on Practising Medicine in 1992, it is stated that “regarding patients to whom a (continued) treatment, based on a medical opinion, has no prospect of success because it would only prolong an ongoing death process, the physician is entitled to, and in certain cases — especially those where a continuation would cause the patient to suffer — also obliged not to initiate a treatment which will only postpone the time of death.“
Examples taken from Guidance Note no. 158 on physicians’ obligations in relation to the content of living wills, item 4.
Guidance Note no. 158, item 5.
The committee-system had, based on the Helsinki-declaration, existed in Denmark since 1980. Before the law was passed, notifying the ethical review committees had not been a legal obligation though.
When a research project concerns clinical testing of medicaments, there is a doble report requirement and in this case the final approval is to be granted by the Pharmaceutical Agency.
With the modification that register research projects and questionnaire research are only to be reported to a regional committee in case the project covers a substantial element of biomedical research or forms part of such a project, and if said project presents a health risk or in any other way can put a strain on the experimental subject in question, cf. section 6 (3) of the act.
Section 23.
Report no. 1335, 1997, Informed Consent in Connection with Research, p. 98.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Hybel, U. (2000). Country Report Denmark. In: Taupitz, J. (eds) Zivilrechtliche Regelungen zur Absicherung der Patientenautonomie am Ende des Lebens / Regulations of Civil Law to Safeguard the Autonomy of Patients at the End of Their Life. Veröffentlichungen des Instituts für Deutsches, Europäisches und Internationales Medizinrecht, Gesundheitsrecht und Bioethik der Universitäten Heidelberg und Mannheim, vol 4. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57256-2_8
Download citation
DOI: https://doi.org/10.1007/978-3-642-57256-2_8
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-67705-5
Online ISBN: 978-3-642-57256-2
eBook Packages: Springer Book Archive