Alternative physicians must also have conventional medicine in mind

BGH demands comparative impact assessment in the case of severe interventions
Alternative treatment methods are legally permissible and therefore can not be considered a mistake from the outset. In particular, in the case of severe interventions physicians then have to keep an eye on conventional medicine and weigh the consequences with their treatment options, the Federal Court of Justice (BGH) in Karlsruhe issued in a judgment published on Monday, 24 July 2017 (Ref .: VI ZR 203 / 16).

In this specific case, we are dealing with a treatment of "holistic dentistry", which focuses more closely on the effects of problems in the mouth on the entire body. In a "hearth and Störfeldtestung" the dentist noted that from sources of inflammation of the teeth protein poisons enter the body - from the right half of the head to the abdomen. The bone of the right upper jaw is inadequately supplied with nutrients and it comes to a "silent tissue descent in the bone marrow".

Cooperation opportunities for naturopaths. Image: F.Schmidt - fotolia

As a therapy, the dentist advised to remove all molars in the upper jaw and thoroughly rake the jawbone. The patient agreed to these measures. The prescribed prosthesis later picked her up at the dental laboratory without having her seat checked and without her being instructed.

Because of difficulties with the dentures, the patient visited another dentist. This commented very critically on the treatment by the colleague.

With her claim, the patient demands reimbursement of the fee paid, the reimbursement of subsequent treatment costs as well as a minimum compensation of 5,000 euros.

District Court and Higher Regional Court (OLG) gave the largely held.

With its ruling of May 30, 2017, published in writing, the Federal Supreme Court annulled the preliminary rulings and referred the dispute back to the OLG Zweibrücken for re-examination. The lower courts had relied on an expert, who is by his own admission not familiar with the basics of holistic dentistry. This is necessary in such cases.

Because the application of not generally recognized forms of therapy is "legally permitted in principle", emphasized the Karlsruhe judges. If patients know the scope of their decision, they may choose "any treatment that does not offend common decency". Therefore, an alternative approach to treatment could not "infer a treatment error from the outset".

However, physicians would always have to weigh the pros and cons for the specific patient with such a treatment. In doing so, they should also have in mind the possibilities of conventional medicine. "The heavier and more radical the intervention in the physical integrity of the patient, the higher the requirements for the medical acceptability of the chosen treatment method," emphasized the Karlsruhe judges.

Here the treatment had considerable consequences. The patient could no longer chew properly without a prosthesis, implants could no longer be inserted into the milled jaw.

The defendant dentist rightly complained about the choice of the appraiser. The commissioned expert suggested two colleagues who are also familiar with holistic dentistry. For he himself could not have judged whether its approach was a justifiable treatment. mwo