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Definition of the problem <p>Seldom does a&#xa0;day go by at the hospital without an admission out of a&#xa0;‚social indication‘. But is it just as easy to speak of a&#xa0;‚social contraindication‘? This topic is avoided in practice since it is sparsely discussed in theory. This article examines the theme of social contraindication from the perspective of clinical neurology. A&#xa0;constructed casuistry contributes to the discussion of social aspects by defining the indication for individual cases. Methodologically, the Bochum Worksheet, conceived by the recently deceased bioethicist Professor Hans-Martin Sass, is revived as an almost forgotten method of ethical case discussion: How should healthcare professionals behave when patients and their relatives have diametrically opposed opinions regarding the situation of dependency so that a&#xa0;beneficial outcome for the patient is jeopardized?</p> Arguments <p>A&#xa0;casuistic study, reflecting on the concepts of medical indication and relational autonomy, explains the omission of medical indication for social reasons from a&#xa0;practical and lifeworld perspective.</p> Conclusions <p>This concept of a&#xa0;social contraindication should be considered as part of the harm-benefit assessment when deciding on the indication, without calling into question the autonomy of the patients themselves. Ethical consultation is a&#xa0;highly established way to secure the dialogue between the parties involved.</p>

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Die „soziale Kontraindikation“: Ein neurologischer Praxisbericht

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月12日

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  • Julius F. W. Schulten

摘要

Definition of the problem

Seldom does a day go by at the hospital without an admission out of a ‚social indication‘. But is it just as easy to speak of a ‚social contraindication‘? This topic is avoided in practice since it is sparsely discussed in theory. This article examines the theme of social contraindication from the perspective of clinical neurology. A constructed casuistry contributes to the discussion of social aspects by defining the indication for individual cases. Methodologically, the Bochum Worksheet, conceived by the recently deceased bioethicist Professor Hans-Martin Sass, is revived as an almost forgotten method of ethical case discussion: How should healthcare professionals behave when patients and their relatives have diametrically opposed opinions regarding the situation of dependency so that a beneficial outcome for the patient is jeopardized?

Arguments

A casuistic study, reflecting on the concepts of medical indication and relational autonomy, explains the omission of medical indication for social reasons from a practical and lifeworld perspective.

Conclusions

This concept of a social contraindication should be considered as part of the harm-benefit assessment when deciding on the indication, without calling into question the autonomy of the patients themselves. Ethical consultation is a highly established way to secure the dialogue between the parties involved.