{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:13:44Z","timestamp":1786979624962,"version":"build-2736575974"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"funder":[{"name":"Herzzentrum G\u00f6ttingen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nervenarzt"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die Elektrokonvulsionstherapie (EKT) ist ein klinisch bew\u00e4hrtes und evidenzbasiertes Verfahren zur Behandlung besonders schwerwiegender oder therapieresistenter psychiatrischer und neuropsychiatrischer St\u00f6rungen. Aus den Indikationen zur EKT ergibt sich, dass ein relevanter Anteil der Patienten mit EKT-Indikation nicht einwilligungsf\u00e4hig ist. Internationale und nationale Arbeiten zeigen, dass bei Betroffenen ohne Einwilligungsf\u00e4higkeit bzw. bei Behandlung gegen den nat\u00fcrlichen Willen (Zwangsbehandlung) restriktive Gesetze und Rechtsprechung die Anwendung der EKT erschweren oder verhindern k\u00f6nnen. Patienten mit Indikation zur EKT und fehlender Einwilligungsf\u00e4higkeit stellen eine vulnerable Personengruppe dar, f\u00fcr die in vielen F\u00e4llen keine gleichwertige Therapiealternative zur Verf\u00fcgung steht. Die Entscheidung \u00fcber eine EKT bei einwilligungsunf\u00e4higen Patienten, insbesondere gegen den nat\u00fcrlichen Willen, ist von hoher rechtlicher und medizinethischer Komplexit\u00e4t, weil je nach Einzelfall sowohl die Durchf\u00fchrung als auch das Unterlassen der Behandlung Grundrechte des Betroffenen verletzen kann. Die verf\u00fcgbare Evidenz bei initial gegen den nat\u00fcrlichen Willen behandelten Patienten zeigt in der Summe gute Ansprechraten sowie identisch hohe retrospektive und zuk\u00fcnftige Zustimmungswerte zur Therapie im Vergleich zur Behandlung mit initialer Einwilligung.<\/jats:p>\n                  <jats:p>Zusammen mit medizinethischen Erw\u00e4gungen kommen die Autoren zu der Schlussfolgerung, dass f\u00fcr die EKT dieselben normativen Ma\u00dfst\u00e4be wie f\u00fcr alle anderen medizinischen Behandlungsverfahren gelten sollten. Dies gilt auch f\u00fcr eine m\u00f6gliche Behandlung gegen den nat\u00fcrlichen Willen. Eine gesonderte und zum Teil restriktivere Handhabung im Vergleich zu anderen medizinischen Ma\u00dfnahmen ist weder medizinisch noch ethisch gerechtfertigt. Strukturelle und juristische H\u00fcrden, die den Zugang schwer und manchmal lebensbedrohlich erkrankter Patientinnen und Patienten zu einer indizierten Behandlung erschweren, sollten hinterfragt und wo m\u00f6glich und notwendig beseitigt werden.<\/jats:p>","DOI":"10.1007\/s00115-025-01816-8","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T06:19:53Z","timestamp":1741155593000},"page":"662-668","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Zugang zur Elektrokonvulsionstherapie bei Menschen mit fehlender Einwilligungsf\u00e4higkeit und als Behandlung gegen den nat\u00fcrlichen Willen","Access to electroconvulsive therapy for people lacking decision making capacity and as nonvoluntary treatment"],"prefix":"10.1007","volume":"96","author":[{"given":"David","family":"Zilles-Wegner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakov","family":"Gather","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkomiet","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen L.","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Pollm\u00e4cher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Simon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilman","family":"Steinert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Sartorius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"1816_CR1","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1056\/NEJMra2034954","volume":"386","author":"RT Espinoza","year":"2022","unstructured":"Espinoza\u00a0RT, Kellner\u00a0CH (2022) Electroconvulsive therapy. 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