[A patient's wishes--the most important law?]

It is a controversial issue in medicine whether the patient's wellbeing or wishes should qualify as treatment criteria. Through the denial of "paternalism" self-determination has become a somewhat lopsided focus of attention. But the principle of caring and doing good is a determinant of clinical action, which is also guided by a respect for autonomy. Even the "medicine of desire" cannot be controlled by the patient's wishes alone. In each case a balance must be sought between these fundamentally equal principles. In aesthetic medicine, for example, merciless frankness and toughness--as has been expressed by the judiciary--may be indicated without further clarification.