["Expected motivation" in managing illness. A difficult social medicine-forensic problem]

The question if a patient can "reasonably be expected to make an effort of will" is of considerable importance when it comes to the psychological assessment of patients under social legislation as well as for private insurances. The problem in this connection is to what extent a human being can reasonably be expected to develop willpower in order to partially or completely overcome his mental/psychosomatic/painful illness with own effort. Even for a neurologist and psychiatrist it is difficult to answer this question, because "willpower or weakness of will" can neither be measured objectively nor can they be determined with the help of psychological tests. We must rather take a decision on the basis of the many years of experience we gained in dealing with patients and our knowledge of various types of personalities, of acquired organic processes of the brain, as well as of an existing social network. Taking all this into account, we must state whether a patient is able to take decisions of will or not. Being the result of an assessment, such a statement is of enormous significance for the patient as far as social and financial aspects are concerned.