[Termination of pregnancy on embryopathic grounds--means to medical decision-making]

Now that german legislators have dispensed with explicit formulation of an embryopathic indication, such cases are covered by the unlimited medical indication as defined under Sec. 218a para, 2 of the German Criminal Code. Determining such an indication "in accordance with medical findings" presents the physician with an extremely difficult diagnostic task. Since basic social consensus does not exist with regard to the content of decisions based on embryopathic grounds, quality assurance measures can only target the decision-making process. The central means that the physician has of determining the extent of the related conflict consists of discussion with the patient of her assessment of the situation. Seen in this context, abolition of the patient's obligation to seek counselling in such cases, as arising in connection with relinquishment of explicit formulation of the embryopathic indication, constitutes an incorrect legislational decision that contradicts the entire concept of the law. On the physician's part, this can be countered by guaranteeing that the patient is provided with comprehensive medical information and encouraging her to partake of in social counselling.