[Medical confidentiality towards family, colleagues and the media from the legal point of view]. / Arztliche Schweigepflicht gegenüber Angehörigen, Kollegen und Medien aus juristischer Sicht.

The more medical confidentiality is endangered in a society based on the exchange of information especially by the welfare system and a health care system relying on the division of labour, the more it must be protected by the law of professional rules and regulations, civil and criminal law. First of all, medical confidentiality refers to the patient who will only confide in his doctor if he can be sure that his secrets will be kept. The individual patients' interests lead directly to the interests of the public health care system which demands confidence and cannot exist without secrecy. The physician may only reveal information if he has the patient's consent which can also be given implied. He can be justified by a presumed consent or the balancing consideration of legally protected values. However, a duty to disclose does not exist. The medical confidentiality applies towards relatives, colleagues who are not consulted by the patient and the media.

[Therapeutic freedom of the physician]. / Therapiefreiheit des Arztes.

The therapeutic freedom of choice is one of the main elements of the medical profession. It is fought for by two competing powers: the patient's will on the one hand, and the reasons of welfare state on the other. A threatened fundamental maxim is at stake, which the characteristic of the medical profession depends on essentially. Its content is to be illustrated and showed clearly in the context of greater interrelations and reciprocity.

[Civil rights responsibility of the physician: content and limits]. / Die zivilrechtliche Einstandspflicht des Arztes: Inhalt und Grenzen.

The article illustrates how court opinion has shaped the malpractice issue for medical doctors during the last 40 years and places this development in the general context of civil liability. Jurisprudence in the higher courts has been generally moderate in its steady interpretation of material and procedural questions to illustrate the issue of contractual liability and negligence for physicians and hospitals and also to secure wide-spread legal precedence. A prediction of the future legal development gives rise, however, to some misgivings. Not only will the issue of negligence without fault be questioned but also that of malpractice. This constitutive element of self-employment must not be weakened in any way. Financial, personal, or equipment deficiencies must not be allowed to become liability risks for medical doctors as a matter of course.

Characterization of two monoclonal antibodies against feline immunodeficiency virus gag gene products and their application in an assay to evaluate neutralizing antibody activity.

Monoclonal antibodies (MAbs) 3B7 and 1C11 were produced against the gag gene products of feline immunodeficiency virus (FIV). These MAbs reacted strongly with FIV p24 in Western blots (immunoblots) and recognized p50 with a lower intensity. They specifically bound antigens in the cytoplasm of FIV-infected cells as determined by indirect immunofluorescence and immunocytochemistry. Although neither MAb inhibited viral replication in vitro, they were useful in a simple assay for the detection and quantification of infectious virus and neutralizing antibody activity. The assay utilizes Crandell feline kidney cells and requires 4 days for completion. Neutralizing antibodies in cats were detected 3 to 4 weeks after experimental infection with FIV. Antibody titres progressively increased during the first year of infection reaching high titres which were maintained 2.5 years post-infection. The MAbs produced should be valuable reagents for the monitoring of viral replication in cells or tissues from FIV-infected cats and for other in vitro applications.

[Legal problems of brain death]. / Juristische Probleme des Hirntodes.

It is necessary to adhere to a uniform time of death. To determine this, the normatively relevant concept of death and the criteria for establishing death in terms of medical proof must be distinguished. The notion of death, which must be determined as a matter of first priority, is not something which is medically predetermined but is a normative convention. According to the legal view prevailling today, this does not depend on complete cessation of biological activities, or on the cessation of heart and breathing activity, but solely on brain death, i.e. (to quote from pertinent commentary of the scientific advisory board of the Federal Chamber of Physicians), on the "complete and irreversible collapse of the overall function of the brain with a circulatory function which can still be maintained in the rest of the body." Brain death is characterized by the irreversible loss of cerebral and brainstem function. Death of the patient is the extreme boundary of therapeutic activity which the physician may not transgress. Irreversible and total loss of function of the brain thus justifies the doctor in discontinuing his measures and indeed compels him to do so. The physician should preserve life and help the dying patient, but should not prolong death. Even before the extreme limit of brain death, intensive therapy may no longer be indicated, so that the physician is not obliged to make further efforts to prolong life.