German Court Upholds Patient’s Right to Leave Property to Doctor, Even Amid Bankruptcy
The right to determine the disposition of one’s assets, even after death, has been affirmed by Germany’s highest civil court, overturning lower court rulings that deemed a property inheritance to a doctor invalid due to potential conflicts of interest. The landmark decision, handed down by the Karlsruhe Senate, underscores the principle of “freedom of testimony” enshrined in German law and raises complex questions about the boundaries of professional ethics.
The case originated in January 2016, when a patient in North Rhine-Westphalia entered into a “care and inheritance contract” with their family doctor. The agreement stipulated that in exchange for ongoing medical care, including home visits and telephone consultations, the doctor would receive ownership of a property upon the patient’s death. Following the patient’s death two years later, the doctor’s subsequent bankruptcy triggered a legal battle, with the insolvency administrator seeking to claim the property as part of the bankruptcy estate.
Initial rulings by the Bielefeld Regional Court and subsequent appeals were unsuccessful for the administrator, but the case continued to climb through the German legal system. Lower courts had invalidated the inheritance, citing regulations from the Westfalen-Lippe medical association that prohibit doctors from accepting gifts or advantages that could compromise their medical independence.
However, the Supreme German Civil Court (BGH) reversed this stance, emphasizing that restricting the patient’s testamentary freedom based on such regulations would be legally untenable. “If the legacy were ineffective, the patient’s freedom of testimony protected in the Basic Law would be restricted,” the court stated. The BGH argued that limitations on this fundamental right must be established by legislation, not by professional associations.
The court acknowledged that the medical association’s regulation – stemming from a model code adopted by the Federal Medical Association – aims to safeguard the integrity of the medical profession and ensure unbiased patient care. However, it determined that professional sanctions imposed by the medical association itself were sufficient to address any potential breaches of ethical conduct. The BGH left open the question of whether the agreement actually violated the regulation in this specific instance.
Despite the BGH’s ruling, the legal saga is not yet over. The Karlsruhe judges have referred the case back to the Higher Regional Court in Hamm, instructing them to investigate whether the inheritance agreement violates “good customs” – a legal principle that could invalidate contracts deemed morally reprehensible. All parties involved will have the opportunity to present arguments on this matter. (Case number: IV ZR 93/24)
According to Torsten Münnch, a specialist lawyer for medical law, the core issue revolves around the perception of influence, rather than actual interference. “It is important that this standard does not matter whether an influence actually takes place,” Münnch explained. “It only depends on whether the impression is given that the independence of the medical decision is influenced.” He noted that a small gesture, like flowers, would likely not raise concerns, but a substantial gift, such as a property, certainly would.
Court decisions on these types of professional regulation violations are relatively rare, Münnch added, as enforcement typically occurs within the medical chambers themselves. He also highlighted the unique aspect of this case: the property was promised through an inheritance contract, rather than a will. A similar case decided by the Higher Regional Court of Frankfurt two years ago upheld the validity of a will in which a man bequeathed his estate to his physician, citing the same principle of testamentary freedom.
The case underscores the delicate balance between upholding professional ethics and respecting an individual’s right to control their own estate. As the legal process continues in Hamm, the outcome will likely have significant implications for similar “care and inheritance” contracts and the broader landscape of patient-physician relationships in Germany.
[Image of a stock photo representing a doctor and patient relationship: beeboys – stock.adobe.com]
