Patientenverfügung — Planning Ahead for Medical Emergencies

What is a Patientenverfügung?

A Patientenverfügung is a document in which you specify which medical measures you wish to receive or refuse — in case you can no longer decide for yourself (e.g., in case of serious illness, accident, unconsciousness, dementia).

Since 2009, the Patientenverfügung has been legally regulated (§ 1827 BGB) and is binding for doctors and guardians.

Why is it important?

Without a Patientenverfügung, doctors and guardians make decisions about your treatment — and not always as you would wish. Typical conflict situations:

• Life-sustaining measures — ventilators, artificial nutrition
• Resuscitation — after cardiac arrest
• Intensive care medicine — in severe illness with no prospect of improvement
• Organ transplantation — organ donation after death

What precautionary measures are available?

There are three important documents that go together:

1. Patientenverfügung

• Regulates medical measures (treatment wishes and refusals)
• Only applies if you can no longer decide for yourself
• Must be in writing (handwritten or printed + signature)
• No notary required — but medical consultation recommended

2. Vorsorgevollmacht

• Appoints a trusted person to make decisions for you when you cannot
• Covers: health, finances, authorities, housing
• Without a Vorsorgevollmacht, the court appoints a guardian — could be a stranger!
• Recommendation: Notarial certification (often required for real estate and bank transactions)

3. Betreuungsverfügung

• Specifies whom the court should appoint as guardian if no authorized representative exists
• You can also specify whom you do not want as guardian

What should be in the Patientenverfügung?

Medical situations

Describe specifically the situations for which your Patientenverfügung should apply:

• Terminal stage of an incurable disease (e.g., end-stage cancer)
• Permanent loss of decision-making capacity (e.g., advanced dementia, persistent vegetative state)
• Acute medical emergency (e.g., cardiac arrest, severe accident)
• Brain damage with permanent unconsciousness

Treatment wishes

For each situation, specify whether you wish or refuse the following measures:

Personal values

Describe your personal values so doctors and guardians better understand your wishes:

• What does quality of life mean to you?
• When would a life no longer be worth living for you?
• What role do religious or cultural beliefs play?
• Do you have fears about certain measures?

How do I create a Patientenverfügung?

Step 1 — Get informed

• Federal Ministry of Justice (bmj.de) — free brochure and text templates
• Consumer centers — guides and forms
• Medical consultation — your family doctor can explain medical aspects

Step 2 — Draft the document

• Use text templates (BMJ brochure) or seek advice
• Formulate specifically (not: "I don't want pointless treatment")
• Describe situations and desired/refused measures

Step 3 — Sign

• Date and signature are required
• Notarial certification is not necessary (but possible)
• Doctor's countersignature recommended (confirms capacity to consent)

Step 4 — Store and inform

• Keep original at home (easily accessible!)
• Copies to: authorized representative, family doctor, close persons
• Information card to carry in wallet (location of Patientenverfügung)
• Central Advance Directive Registry — registration with Federal Notary Chamber (zvr-online.de, fee: 13–20 €) — courts and hospitals can check there

Step 5 — Review regularly

• Review the Patientenverfügung every 2–3 years
• New signature with date — confirms you stand by your wishes
• When life circumstances change (e.g., serious illness, divorce), update accordingly

Costs

Validity

• No expiration date — the Patientenverfügung remains valid until you revoke it
• Can be revoked anytime — verbally or in writing, even informally
• Minors cannot create a valid Patientenverfügung (only from age 18)
• Regular confirmation (new signature + date) strengthens binding effect

Special considerations for foreigners

Does the Patientenverfügung apply abroad?

• A German Patientenverfügung is basically valid only in Germany
• In EU countries it is often recognized, but not guaranteed
• Recommendation: Create a bilingual version (German + your native language)

Religious and cultural aspects

• Islam: Life-sustaining measures are often favored, organ donation is controversial
• Christianity: Self-determination at end of treatment is accepted
• Judaism: Life preservation has high value
• Buddhism/Hinduism: Varying views on assisted dying

Important: The Patientenverfügung respects your personal decision — regardless of religious rules.

Tips

1. Create it now — don't wait for illness, an accident can happen to anyone
2. Don't forget Vorsorgevollmacht — it's at least as important as the Patientenverfügung
3. Include your trusted person — discuss your wishes openly
4. Consult your family doctor — clarify medical terminology
5. Carry an information card — in your wallet so everything can be found in an emergency

Status: March 2026. All information without warranty.