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In der t\u00e4glichen Praxis stellt sich dann die Frage, inwieweit der ge\u00e4u\u00dferte Wille des Patienten die Behandlungsschritte vorgibt oder ob eine Entscheidung gegen den Willen des Patienten medizinisch sinnvoll, ethisch vertretbar oder sogar geboten und rechtlich zul\u00e4ssig ist. Autoimmune Enzephalitiden \u2013 wie die N\u2011Methyl-D-Aspartat-Rezeptor(NMDAR)-Enzephalitis \u2013 sind aufgrund ihrer relativen H\u00e4ufigkeit, vielgestaltigen Symptomatik und guten Therapierbarkeit neuerdings wichtige Differenzialdiagnosen, da die zugrunde liegenden Autoantik\u00f6rper besonders h\u00e4ufig zu organischen Psychosen f\u00fchren. Am Beispiel eines komplexen Falles einer Patientin mit im Verlauf gesicherter NMDAR-Enzephalitis erl\u00e4utern wir die praxisrelevanten ethisch-juristischen Abw\u00e4gungen von der initialen invasiven Diagnostik bis zur Unterbringung und Zwangsbehandlung. Die Bewertung soll konkrete Hilfestellungen geben, die Autonomie des Patienten zu respektieren, potenzielle Widerspr\u00fcche zwischen dem freien Willen und dem ge\u00e4u\u00dferten Willen zu ermessen, individuelle \u00e4rztliche \u00dcberzeugungen (hinsichtlich Autonomief\u00e4higkeit und Zwangsbehandlung) anhand der Rechtslage zu \u00fcberpr\u00fcfen, die Indikation f\u00fcr eine vor\u00fcbergehende Behandlung gegen den nat\u00fcrlichen Willen zu stellen, Analogien zu anderen schweren Hirnerkrankungen herzustellen und erfolgreich gegen\u00fcber dem Betreuungsgericht zu argumentieren.<\/jats:p>","DOI":"10.1007\/s00115-019-00802-1","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T11:03:24Z","timestamp":1568891004000},"page":"122-130","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Autoimmune Enzephalitiden \u2013 diagnostischer und therapeutischer Entscheidungsbaum aus psychiatrischer, neurologischer und ethisch-juristischer Sicht","Autoimmune encephalitis\u2014Diagnostic and therapeutic decision tree from a psychiatric, neurological and ethico-legal point of view"],"prefix":"10.1007","volume":"91","author":[{"given":"Harald","family":"Pr\u00fc\u00df","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"K\u00f6hler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,9,19]]},"reference":[{"key":"802_CR1","first-page":"216","volume-title":"Principles of biomedical ethics","author":"TL Beauchamp","year":"2013","unstructured":"Beauchamp\u00a0TL, Childress\u00a0JF (2013) Principles of biomedical ethics, 7.\u00a0Aufl. 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