[Economical constraints and anaesthesiological standards]

At least 10 years ago the the Federal High Court stressed that a legal claim to the "best possible" anaesthesiological care does not exist. Due to limited financial resources, that which is medically feasible becomes more and more limited by the economical constraints. The question is discussed which cutbacks must be accepted by the medical profession and the patients and how is the difference between "optimal" and "acceptable" standards to be defined. Standards in medicine are dynamic and are influenced by medical knowledge as well as national economic, legal and cultural circumstances. Hence it is valid to say: when all reserves have been exhausted and even by the best possible organisation certain standards cannot be maintained or undertaken and/or promising diagnoses or therapies cannot be carried out, the valid legal standard for assessment of the most appropriate anaesthesiological procedure is lowered. Medical ideal and objective standards to assess the necessary scrupulousness of medical personnel must therefore be adapted and lowered.